Provider Demographics
NPI:1881039832
Name:NEVELOW, RONALD (LCSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:NEVELOW
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:RON
Other - Middle Name:
Other - Last Name:NEVELOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:6939 MILL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2913
Mailing Address - Country:US
Mailing Address - Phone:214-563-2126
Mailing Address - Fax:
Practice Address - Street 1:12880 HILLCREST RD
Practice Address - Street 2:STE. J104
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1532
Practice Address - Country:US
Practice Address - Phone:214-563-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical