Provider Demographics
NPI:1992846000
Name:ZUMSTEIN, RONALD (MSW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:ZUMSTEIN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 WESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1815
Mailing Address - Country:US
Mailing Address - Phone:919-235-0678
Mailing Address - Fax:
Practice Address - Street 1:4611 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1815
Practice Address - Country:US
Practice Address - Phone:919-235-0678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0025561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD9027OtherMEDCOST ID
NC10065OtherBLUE CROSS BLUE SHIELD