Provider Demographics
NPI:1609936426
Name:SIPKO, RONALD J (MFT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:SIPKO
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:876 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-8857
Mailing Address - Country:US
Mailing Address - Phone:775-781-4642
Mailing Address - Fax:775-782-4216
Practice Address - Street 1:1528 HWY 395
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410
Practice Address - Country:US
Practice Address - Phone:775-781-4642
Practice Address - Fax:775-782-4216
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0334106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist