Provider Demographics
NPI:1598212292
Name:WELSCH, RONALD DAVID (LMFT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DAVID
Last Name:WELSCH
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 TAINTER ST UNIT G
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-8200
Mailing Address - Country:US
Mailing Address - Phone:715-231-4373
Mailing Address - Fax:
Practice Address - Street 1:1700 TAINTER ST, UNIT G
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1566
Practice Address - Country:US
Practice Address - Phone:715-231-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1204-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100079136Medicaid