Provider Demographics
NPI:1609095736
Name:RONKA, ELLEN BETH (LCMHC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:BETH
Last Name:RONKA
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 LAFAYETTE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2445
Mailing Address - Country:US
Mailing Address - Phone:603-964-1700
Mailing Address - Fax:603-964-1701
Practice Address - Street 1:216 LAFAYETTE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2445
Practice Address - Country:US
Practice Address - Phone:603-964-1700
Practice Address - Fax:603-964-1701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health