Provider Demographics
NPI:1255678488
Name:RAMIREZ, JENNIFER LYN (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 BRIGHTON CT
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3219
Mailing Address - Country:US
Mailing Address - Phone:409-779-6730
Mailing Address - Fax:409-299-9551
Practice Address - Street 1:1670 BRIGHTON CT
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3219
Practice Address - Country:US
Practice Address - Phone:409-779-6730
Practice Address - Fax:409-299-9551
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86333101YP2500X
TX251C00000X, 251S00000X, 252Y00000X
253Z00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care