Provider Demographics
NPI:1639259484
Name:CHUMLEY, RONALD ONARD (LPC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ONARD
Last Name:CHUMLEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 150538
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-0538
Mailing Address - Country:US
Mailing Address - Phone:936-632-2242
Mailing Address - Fax:936-632-2242
Practice Address - Street 1:531 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3127
Practice Address - Country:US
Practice Address - Phone:936-632-2242
Practice Address - Fax:936-632-2242
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10023101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1353LCOtherBLUECROSSBLUE SHIELD
TX0952509-02Medicaid