Provider Demographics
NPI:1881916096
Name:GOLSTON, RONALD J (MSW, LSW, LMFT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:GOLSTON
Suffix:
Gender:M
Credentials:MSW, LSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-2746
Mailing Address - Country:US
Mailing Address - Phone:219-979-0900
Mailing Address - Fax:219-979-7615
Practice Address - Street 1:501 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-2746
Practice Address - Country:US
Practice Address - Phone:219-979-0900
Practice Address - Fax:219-979-7615
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33001144A104100000X
IN35000561A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist