Provider Demographics
NPI:1689738734
Name:NOLLEY, RONALD EUGENE (LCSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EUGENE
Last Name:NOLLEY
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 1:219 E DAVIS ST
Mailing Address - Street 2:STE 310
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3001
Mailing Address - Country:US
Mailing Address - Phone:540-825-2788
Mailing Address - Fax:540-825-1244
Practice Address - Street 1:219 E DAVIS ST
Practice Address - Street 2:STE 310
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3001
Practice Address - Country:US
Practice Address - Phone:540-825-2788
Practice Address - Fax:540-825-1244
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040013661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04329Medicare PIN
VAW36728Medicare UPIN