Provider Demographics
NPI:1922193747
Name:BONHEUR, RONALD L G (LCSW)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L G
Last Name:BONHEUR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5939 VILLAGE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-3212
Mailing Address - Country:US
Mailing Address - Phone:757-484-4025
Mailing Address - Fax:757-484-4103
Practice Address - Street 1:5939 VILLAGE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3212
Practice Address - Country:US
Practice Address - Phone:757-484-4025
Practice Address - Fax:757-484-4103
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040008721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical