Provider Demographics
NPI:1942936323
Name:RONAYNE, NICOLE CATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:CATHERINE
Last Name:RONAYNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5598 HOBSONS CHOICE LOOP
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5468
Mailing Address - Country:US
Mailing Address - Phone:205-541-8380
Mailing Address - Fax:
Practice Address - Street 1:12781 DARBY BROOK CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2482
Practice Address - Country:US
Practice Address - Phone:571-406-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health