Provider Demographics
NPI:1467014282
Name:FLEMING, RONALD CHARLES SR (LLPC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:CHARLES
Last Name:FLEMING
Suffix:SR
Gender:M
Credentials:LLPC
Other - Prefix:MR
Other - First Name:RONALD
Other - Middle Name:C
Other - Last Name:FLEMING
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:LLPC
Mailing Address - Street 1:6408 ENCANTADO CT E
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9677
Mailing Address - Country:US
Mailing Address - Phone:616-308-1534
Mailing Address - Fax:
Practice Address - Street 1:6408 ENCANTADO CT E
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9677
Practice Address - Country:US
Practice Address - Phone:616-308-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health