Provider Demographics
NPI:1720265465
Name:BRUMPTON, RONA M (LCPC, LMFT)
Entity Type:Individual
Prefix:
First Name:RONA
Middle Name:M
Last Name:BRUMPTON
Suffix:
Gender:F
Credentials:LCPC, LMFT
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 768
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-4500
Mailing Address - Country:US
Mailing Address - Phone:208-859-7435
Mailing Address - Fax:208-461-7230
Practice Address - Street 1:213 11TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3920
Practice Address - Country:US
Practice Address - Phone:208-859-7435
Practice Address - Fax:208-461-7230
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-378101YM0800X
IDLMFT-2861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health