Provider Demographics
NPI:1568608289
Name:HARRIS, RONALD EARL (LSW LCDCIII)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:EARL
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LSW LCDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24200 CHAGRIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5550
Mailing Address - Country:US
Mailing Address - Phone:216-831-6466
Mailing Address - Fax:216-766-6084
Practice Address - Street 1:24200 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5550
Practice Address - Country:US
Practice Address - Phone:216-831-6466
Practice Address - Fax:216-766-6084
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH975919101YA0400X
OHS0022389101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health