Provider Demographics
NPI:1164108601
Name:MORAN, RONALD WESSON III (LPC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WESSON
Last Name:MORAN
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1764 WILLARD WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2782
Mailing Address - Country:US
Mailing Address - Phone:770-750-5042
Mailing Address - Fax:
Practice Address - Street 1:1764 WILLARD WAY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3919
Practice Address - Country:US
Practice Address - Phone:706-266-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82135101YP2500X
GALPC010578101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional