Provider Demographics
NPI:1750532370
Name:CAW, RONI L (PHD, LPC)
Entity type:Individual
Prefix:MR
First Name:RONI
Middle Name:L
Last Name:CAW
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 BELLEVIEW ST STE 103
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1839
Mailing Address - Country:US
Mailing Address - Phone:803-728-0497
Mailing Address - Fax:803-764-4028
Practice Address - Street 1:1115 BELLEVIEW ST STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1839
Practice Address - Country:US
Practice Address - Phone:803-728-0497
Practice Address - Fax:803-764-4028
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional