Provider Demographics
NPI:1891573986
Name:MAYO, RONALD RAFAEL SR
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:RAFAEL
Last Name:MAYO
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 SATTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-6964
Mailing Address - Country:US
Mailing Address - Phone:252-529-0202
Mailing Address - Fax:252-631-5449
Practice Address - Street 1:310 CRAVEN ST STE 10
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4983
Practice Address - Country:US
Practice Address - Phone:252-675-4355
Practice Address - Fax:252-631-5449
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral