Provider Demographics
NPI:1497456933
Name:RAMIREZ, MELISSA (LSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W IRVING PARK RD APT 5214
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6307
Mailing Address - Country:US
Mailing Address - Phone:305-331-5814
Mailing Address - Fax:
Practice Address - Street 1:655 W IRVING PARK RD APT 5214
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-6307
Practice Address - Country:US
Practice Address - Phone:305-331-5814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150109153104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker