Provider Demographics
NPI:1932736899
Name:MILLER, RONALD K (CDCA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:K
Last Name:MILLER
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49008 FREDRICKTOWN CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:NEGLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44441-9716
Mailing Address - Country:US
Mailing Address - Phone:330-383-7030
Mailing Address - Fax:
Practice Address - Street 1:150 CHARLES CT
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1715
Practice Address - Country:US
Practice Address - Phone:330-953-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.172746101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)