Provider Demographics
NPI:1265515167
Name:WELCH, RONALD LEROY (MA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEROY
Last Name:WELCH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 238TH
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68405-8439
Mailing Address - Country:US
Mailing Address - Phone:140-276-1232
Mailing Address - Fax:140-276-1232
Practice Address - Street 1:560 238TH
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NE
Practice Address - Zip Code:68405-8439
Practice Address - Country:US
Practice Address - Phone:140-276-1232
Practice Address - Fax:140-276-1232
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health