Provider Demographics
NPI:1821540238
Name:RODLAND, RALPH (CSAC)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:RODLAND
Suffix:
Gender:M
Credentials:CSAC
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 5693
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-5693
Mailing Address - Country:US
Mailing Address - Phone:336-822-2827
Mailing Address - Fax:336-883-4015
Practice Address - Street 1:910 MILL AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-1628
Practice Address - Country:US
Practice Address - Phone:336-822-2827
Practice Address - Fax:336-883-4015
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21173101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)