Provider Demographics
NPI:1760469324
Name:UNGER, RON (LCSW)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:UNGER
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 1:1770 AUGUSTA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-2209
Mailing Address - Country:US
Mailing Address - Phone:541-513-1811
Mailing Address - Fax:541-686-2440
Practice Address - Street 1:1210 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3573
Practice Address - Country:US
Practice Address - Phone:541-513-1811
Practice Address - Fax:844-729-1748
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL33451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORJ0147OtherPACIFIC SOURCE ID NUMBER
2003850-01OtherREGENCE PROVIDER NUMBER
ORR131368Medicare PIN