Provider Demographics
NPI:1467736488
Name:SEVERNS, RONALD D (LCSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:SEVERNS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 N DOUTY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3722
Mailing Address - Country:US
Mailing Address - Phone:559-589-2310
Mailing Address - Fax:559-589-2209
Practice Address - Street 1:1025 N DOUTY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3722
Practice Address - Country:US
Practice Address - Phone:559-589-2310
Practice Address - Fax:559-589-2209
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS254431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical