Provider Demographics
NPI:1457627200
Name:RAMON, MICHELLI (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLI
Middle Name:
Last Name:RAMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8604 RAINTREE HL
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4404
Mailing Address - Country:US
Mailing Address - Phone:210-316-4057
Mailing Address - Fax:
Practice Address - Street 1:8604 RAINTREE HL
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015-4404
Practice Address - Country:US
Practice Address - Phone:210-316-4057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX423811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX42381OtherLCSW NO.