Provider Demographics
NPI:1871000869
Name:BEARD, RONALD ALLEN (MHS, CAADC, ICADC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ALLEN
Last Name:BEARD
Suffix:
Gender:M
Credentials:MHS, CAADC, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CARVER RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2716
Mailing Address - Country:US
Mailing Address - Phone:302-883-7883
Mailing Address - Fax:
Practice Address - Street 1:44 CARVER ROAD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-883-7883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE592101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)