Provider Demographics
NPI:1013528637
Name:GLOSTON, RONALD J JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:GLOSTON
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 24TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4804
Mailing Address - Country:US
Mailing Address - Phone:202-845-2805
Mailing Address - Fax:
Practice Address - Street 1:2110 PRIEST BRIDGE DR STE 1
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2472
Practice Address - Country:US
Practice Address - Phone:443-937-7089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty