Provider Demographics
NPI:1679780589
Name:BAIER, RONALD J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:BAIER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1342 COLONIAL BLVD
Mailing Address - Street 2:SUITE H-64
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1013
Mailing Address - Country:US
Mailing Address - Phone:239-274-0676
Mailing Address - Fax:239-274-0675
Practice Address - Street 1:1342 COLONIAL BLVD
Practice Address - Street 2:SUITE H-64
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1013
Practice Address - Country:US
Practice Address - Phone:239-274-0676
Practice Address - Fax:239-274-0675
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ024QOtherBLUE CROSS BLUE SHIELD