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General NPI Number Information
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NPI Number | 1912063330
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Entity Type | Individual
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Provider Name | RONALD M BACKER LPC
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 100 MARKET SQ SUITE #6
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City | NEWINGTON
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State | CT
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Zip | 06111-2921
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Country | US
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Telephone | 860-667-1153
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Fax | 860-436-4083
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Provider Business Mailing Address
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Address Line | 100 MARKET SQ SUITE #6
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City | NEWINGTON
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State | CT
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Zip | 06111-2921
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Country | US
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Telephone | 860-667-1153
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Fax | 860-436-4083
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001361
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | CT
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