Individual
MR. RONALD T FAIRCLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LISAC
Contact information
Practice address
3127 W GIBSON LN, PHOENIX, AZ 85009-6212
(602) 876-1715
Mailing address
1018 E OSBORN RD, UNIT F, PHOENIX, AZ 85014-5295
(602) 234-1990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11421
AZ
101YP2500X
Professional Counselor
LPC-11915
AZ
Other
Enumeration date
05/10/2007
Last updated
09/11/2025
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