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General NPI Number Information
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NPI Number | 1780923649
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Entity Type | Individual
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Provider Name | RALPH MICHAEL MCMENEMY LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1023 OLD GAINESVILLE HIGHWAY
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City | INTERLACHEN
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State | FL
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Zip | 32148
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Country | US
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Telephone | 410-299-9821
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 OLD GAINESVILLE HWY
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City | INTERLACHEN
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State | FL
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Zip | 32148-5435
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Country | US
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Telephone | 410-299-9821
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Fax | 757-210-5988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05070
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License Number State | MD
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