Provider Demographics
NPI:1700030236
Name:MOORE-RAMIREZ, AMY MARIE (MAED, LPCC, LSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:MOORE-RAMIREZ
Suffix:
Gender:F
Credentials:MAED, LPCC, LSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1653 MERRIMAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5210
Mailing Address - Country:US
Mailing Address - Phone:330-641-2151
Mailing Address - Fax:
Practice Address - Street 1:1653 MERRIMAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5210
Practice Address - Country:US
Practice Address - Phone:330-641-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00259771041C0700X
OHE.1700181101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health