Provider Demographics
NPI:1285844373
Name:RAMOS, DIVINA MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:DIVINA
Middle Name:MARIE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 STONE PINE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-6195
Mailing Address - Country:US
Mailing Address - Phone:575-571-7449
Mailing Address - Fax:
Practice Address - Street 1:2260 STONE PINE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-6195
Practice Address - Country:US
Practice Address - Phone:575-571-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0124201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional