Provider Demographics
NPI:1174804082
Name:RINGOLD, LARONDA
Entity type:Individual
Prefix:
First Name:LARONDA
Middle Name:
Last Name:RINGOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 LOS FELIZ ST
Mailing Address - Street 2:UNIT 136
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-7199
Mailing Address - Country:US
Mailing Address - Phone:810-625-0289
Mailing Address - Fax:
Practice Address - Street 1:3455 W. CRAIG ROAD, SUITE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-982-0060
Practice Address - Fax:702-418-1991
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE355488376265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health