Provider Demographics
NPI:1386853679
Name:RAMIREZ, RAOUL (LCSW)
Entity Type:Individual
Prefix:
First Name:RAOUL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 URANUS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8640
Mailing Address - Country:US
Mailing Address - Phone:631-744-7955
Mailing Address - Fax:
Practice Address - Street 1:49 URANUS RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8640
Practice Address - Country:US
Practice Address - Phone:631-744-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR028857-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical