Provider Demographics
NPI:1649817560
Name:NORMAN, RONALD KEITH JR (LCPC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:KEITH
Last Name:NORMAN
Suffix:JR
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 MEEKER AVE # 143
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-6410
Mailing Address - Country:US
Mailing Address - Phone:510-944-6800
Mailing Address - Fax:
Practice Address - Street 1:2163 MEEKER AVE # 143
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-6410
Practice Address - Country:US
Practice Address - Phone:510-944-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10076101Y00000X, 101YA0400X, 101YP1600X, 101YM0800X
CA8159390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program