Ronald J Malott, LADAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Raton, NM
NPI 1922064104 · NPPES record last updated Jan 26, 2015
Key facts
- NPI
- 1922064104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 3757 (NM)
- Practice address
- 213 N. 2ND Street
Raton, NM 87740 - Phone
- (575) 445-9761
- Fax
- (575) 445-2887
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3757 | NM | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3757 | NM | Yes |
Addresses
Primary practice location
213 N. 2ND Street
Raton, NM 87740
Mailing address
RR 1 Box 56a
Springer, NM 87747-9703
Phone (575) 483-2480
Other providers in Raton, NM
- Matthew Lucero
- Rudy A Lucero
- Shawnie Gloria Macelroy
- Valerie Maestas
- Anita Mallory
- Roxann Mares
- Daniel Marez
- Elizabeth A Martinez
- Janelle Martinez
- Jessica Charlotte Martinez
All providers in Raton, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.