Provider Demographics
NPI:1487106209
Name:ROSTON, RAMONA (LICENSED SOCIAL WORK)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:ROSTON
Suffix:
Gender:F
Credentials:LICENSED SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 LAKE RIDGE RD
Mailing Address - Street 2:APT 2218
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4700
Mailing Address - Country:US
Mailing Address - Phone:214-872-9004
Mailing Address - Fax:214-872-9004
Practice Address - Street 1:2600 LAKE RIDGE RD APT 3119
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-4709
Practice Address - Country:US
Practice Address - Phone:816-898-3613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45031041C0700X
TX628521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical