Provider Demographics
NPI:1477126225
Name:SUMMA, RONALD JOSEPH (LCSW AND LADC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JOSEPH
Last Name:SUMMA
Suffix:
Gender:M
Credentials:LCSW AND LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 ORONOKE RD APT 8-1
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3938
Mailing Address - Country:US
Mailing Address - Phone:203-232-2147
Mailing Address - Fax:
Practice Address - Street 1:25 ELM ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2305
Practice Address - Country:US
Practice Address - Phone:860-563-8800
Practice Address - Fax:860-563-8805
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0113091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical