Provider Demographics
NPI:1508827569
Name:WHITE, RONDA JEAN (LMFT LPP TP MA)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:JEAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMFT LPP TP MA
Other - Prefix:
Other - First Name:RONDA
Other - Middle Name:JEAN
Other - Last Name:HESKIN LEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8 N 2ND AVE E
Mailing Address - Street 2:STE 300
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:53802
Mailing Address - Country:US
Mailing Address - Phone:218-727-5400
Mailing Address - Fax:218-727-0077
Practice Address - Street 1:8 N 2ND AVE E
Practice Address - Street 2:STE 300
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:53802
Practice Address - Country:US
Practice Address - Phone:218-727-5400
Practice Address - Fax:218-727-0077
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPP0047103T00000X
MNMFT843106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
099L2KROtherBCBS GROUP
099L3HEOtherBCBS INDIVIDUAL