Provider Demographics
NPI:1710476106
Name:RAMSDALE, CELINA MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CELINA
Middle Name:MARIE
Last Name:RAMSDALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CELINA
Other - Middle Name:MARIE
Other - Last Name:CASTELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2221 EAGAN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5730
Mailing Address - Country:US
Mailing Address - Phone:907-458-2250
Mailing Address - Fax:907-456-7250
Practice Address - Street 1:2221 EAGAN AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5730
Practice Address - Country:US
Practice Address - Phone:907-458-2250
Practice Address - Fax:907-456-7250
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK103059104100000X
TX56083104100000X
AL2917G104100000X
AK1233321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker