Provider Demographics
NPI:1518425065
Name:RAMSEY, JEAN LOUISE
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:LOUISE
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 LARA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-4121
Mailing Address - Country:US
Mailing Address - Phone:505-379-8832
Mailing Address - Fax:
Practice Address - Street 1:OFFICE ALTERNATIVES/ THE CENTER FOR LIFE CHANGES
Practice Address - Street 2:6300 RIVERSIDE PLAZA NW, SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120
Practice Address - Country:US
Practice Address - Phone:505-336-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0104591101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC79183OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS, INC
NMCCMH0104591OtherLPCC LICENSE ISSUED BY STATE