Provider Demographics
NPI:1336734227
Name:UMLES, RONNI CARLA (MHC)
Entity Type:Individual
Prefix:
First Name:RONNI
Middle Name:CARLA
Last Name:UMLES
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EMPIRE BLVD APT 7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3337
Mailing Address - Country:US
Mailing Address - Phone:949-466-7234
Mailing Address - Fax:
Practice Address - Street 1:875 6TH AVE RM 1602
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3574
Practice Address - Country:US
Practice Address - Phone:732-778-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP108791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health