1518425065 NPI number — JEAN LOUISE RAMSEY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518425065 NPI number — JEAN LOUISE RAMSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMSEY
Provider First Name:
JEAN
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518425065
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4021 LARA DR NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87111-4121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-379-8832
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
OFFICE ALTERNATIVES/ THE CENTER FOR LIFE CHANGES
Provider Second Line Business Practice Location Address:
6300 RIVERSIDE PLAZA NW, SUITE 100
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-336-5650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0104591 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NCC79183 . This is a "NATIONAL BOARD FOR CERTIFIED COUNSELORS, INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: CCMH0104591 . This is a "LPCC LICENSE ISSUED BY STATE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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