Provider Demographics
NPI:1093062945
Name:RAM, SANGEET (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SANGEET
Middle Name:
Last Name:RAM
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:DELPHINE
Other - Middle Name:MARIE
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 OFFICE COURT DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-4903
Mailing Address - Country:US
Mailing Address - Phone:505-983-8225
Mailing Address - Fax:505-395-7406
Practice Address - Street 1:4001 OFFICE COURT DR STE 102
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4903
Practice Address - Country:US
Practice Address - Phone:505-983-8225
Practice Address - Fax:505-395-7406
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11362101YM0800X
NMCCMH0197101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74620380Medicaid