Provider Demographics
NPI:1831295351
Name:LINGLE, RONALD MARK (MA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MARK
Last Name:LINGLE
Suffix:
Gender:M
Credentials:MA
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 12
Mailing Address - Street 2:
Mailing Address - City:HYDE
Mailing Address - State:PA
Mailing Address - Zip Code:16843-0012
Mailing Address - Country:US
Mailing Address - Phone:814-765-6941
Mailing Address - Fax:814-765-6941
Practice Address - Street 1:109 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-2412
Practice Address - Country:US
Practice Address - Phone:814-765-6941
Practice Address - Fax:814-765-6941
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006004L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling