Provider Demographics
NPI:1710498076
Name:RAMOS, LORENA SABRINA (MA, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:SABRINA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MA, MSW, LCSW
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:S
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MSW, LCSW
Mailing Address - Street 1:2711 N KENMORE AVE APT F1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1376
Mailing Address - Country:US
Mailing Address - Phone:312-279-8870
Mailing Address - Fax:
Practice Address - Street 1:2711 N KENMORE AVE APT F1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1376
Practice Address - Country:US
Practice Address - Phone:312-279-8870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0194121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical