Provider Demographics
NPI:1467675140
Name:RAMIREZ, MARCHETTA A (LMSW-ACP)
Entity Type:Individual
Prefix:
First Name:MARCHETTA
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LMSW-ACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2033
Mailing Address - Country:US
Mailing Address - Phone:512-322-0006
Mailing Address - Fax:
Practice Address - Street 1:707 W 10TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2033
Practice Address - Country:US
Practice Address - Phone:512-322-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S33NOtherBLUECROSSBLUESHIELD PROVI