Provider Demographics
NPI:1538679618
Name:WOODSON, RANSOM JUNO
Entity Type:Individual
Prefix:
First Name:RANSOM
Middle Name:JUNO
Last Name:WOODSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12529 COURSEY BLVD APT 1075
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4514
Mailing Address - Country:US
Mailing Address - Phone:202-230-6525
Mailing Address - Fax:
Practice Address - Street 1:12529 COURSEY BLVD APT 1075
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4514
Practice Address - Country:US
Practice Address - Phone:202-230-6525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist