Provider Demographics
NPI:1467576504
Name:RONNAU, JOANNA MAXWELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MAXWELL
Last Name:RONNAU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MAXWELL
Other - Last Name:PROVINCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6683
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-750-4843
Practice Address - Street 1:115 S 3RD ST
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543
Practice Address - Country:US
Practice Address - Phone:501-206-0831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1301003101YM0800X, 101YP2500X
ARA0702025101YP2500X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator