Provider Demographics
NPI:1326493735
Name:RAMIREZ, JORDAN J (LCSW-10619-C)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:J
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LCSW-10619-C
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:J
Other - Last Name:HOLBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:CARLIN
Mailing Address - State:NV
Mailing Address - Zip Code:89822
Mailing Address - Country:US
Mailing Address - Phone:775-385-4479
Mailing Address - Fax:
Practice Address - Street 1:1525 OPAL DR UNIT G200
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-3452
Practice Address - Country:US
Practice Address - Phone:775-385-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NV10619-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner