Provider Demographics
NPI:1760546972
Name:HUMBERT, RONALD LEE (NYS LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEE
Last Name:HUMBERT
Suffix:
Gender:M
Credentials:NYS LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WOLFS LANE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2108
Mailing Address - Country:US
Mailing Address - Phone:914-738-6508
Mailing Address - Fax:914-738-5945
Practice Address - Street 1:303 WOLFS LANE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-2108
Practice Address - Country:US
Practice Address - Phone:914-738-6508
Practice Address - Fax:914-738-5945
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030139-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical