Provider Demographics
NPI:1003490418
Name:RAMIREZ, KAREN VICTORIA (LPC #79287)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:VICTORIA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LPC #79287
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 PROVINCE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3961
Mailing Address - Country:US
Mailing Address - Phone:254-295-6495
Mailing Address - Fax:
Practice Address - Street 1:1350 N BUCKNER BLVD STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3566
Practice Address - Country:US
Practice Address - Phone:469-490-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health