Provider Demographics
NPI:1376970244
Name:HEATHER RAM, LMFT, LLC
Entity Type:Organization
Organization Name:HEATHER RAM, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-305-4500
Mailing Address - Street 1:438 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3396
Mailing Address - Country:US
Mailing Address - Phone:860-305-4500
Mailing Address - Fax:
Practice Address - Street 1:29 EVERGREEN TER
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-1404
Practice Address - Country:US
Practice Address - Phone:860-305-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1605106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty