Provider Demographics
NPI:1295245892
Name:RONEY, RONTO (LPC CDC II)
Entity type:Individual
Prefix:
First Name:RONTO
Middle Name:
Last Name:RONEY
Suffix:
Gender:M
Credentials:LPC CDC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 902
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0902
Mailing Address - Country:US
Mailing Address - Phone:908-461-8114
Mailing Address - Fax:
Practice Address - Street 1:479 MISSION ST APT B1
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-0009
Practice Address - Country:US
Practice Address - Phone:908-461-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0998550101YA0400X
NJLPCC0015677101YA0400X
COLPC.0015093101YP2500X
AK150864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)