Provider Demographics
NPI:1619598562
Name:RAMIREZ, JOSE TALAMANTEZ JR (LMSW, LCDC)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:TALAMANTEZ
Last Name:RAMIREZ
Suffix:JR
Gender:M
Credentials:LMSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5866 S STAPLES ST STE 330
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3785
Mailing Address - Country:US
Mailing Address - Phone:361-739-5487
Mailing Address - Fax:
Practice Address - Street 1:5866 S STAPLES ST STE 330
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3785
Practice Address - Country:US
Practice Address - Phone:361-739-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10644101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)