Provider Demographics
NPI:1629133749
Name:RAMOS, ELAINE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:M
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:M
Other - Last Name:BLUMENAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2 LOREL LN
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-4314
Mailing Address - Country:US
Mailing Address - Phone:845-255-8014
Mailing Address - Fax:845-255-8014
Practice Address - Street 1:2 LOREL LN
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-4314
Practice Address - Country:US
Practice Address - Phone:845-255-8014
Practice Address - Fax:845-255-8014
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR017120-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY143464OtherID# VALUE OPTIONS
NYP3065620OtherPROV.# OXFORD
NYP306-5620OtherPROV.# MH NETWORK
NY749-279-8002Medicare UPIN
NY143464OtherID# VALUE OPTIONS