Provider Demographics
NPI:1609027648
Name:KEY, RONALD L (PHD, CEAP,AADC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:KEY
Suffix:
Gender:M
Credentials:PHD, CEAP,AADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 N PINE RD
Mailing Address - Street 2:
Mailing Address - City:OLLA
Mailing Address - State:LA
Mailing Address - Zip Code:71465-4804
Mailing Address - Country:US
Mailing Address - Phone:318-495-3131
Mailing Address - Fax:318-495-0749
Practice Address - Street 1:442 JORDAN ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4849
Practice Address - Country:US
Practice Address - Phone:318-426-7020
Practice Address - Fax:318-425-1828
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024471101Y00000X
LA452101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor