Provider Demographics
NPI:1639217656
Name:RAMIREZ, ANNE KELLSTEDT (MS LCPC)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:KELLSTEDT
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MS LCPC
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Mailing Address - Street 1:146 E BLAIR ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185
Mailing Address - Country:US
Mailing Address - Phone:630-293-5956
Mailing Address - Fax:630-893-7481
Practice Address - Street 1:125 S BLOOMINGDALE RD
Practice Address - Street 2:12
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-231-5960
Practice Address - Fax:630-893-7481
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2228050OtherBLUE CROSS BLUE SHIELD IL