Provider Demographics
NPI:1134216971
Name:RAMU, PHILIP MANUEL (LCSW)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:MANUEL
Last Name:RAMU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FERNALD STREET
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04294
Mailing Address - Country:US
Mailing Address - Phone:207-645-2896
Mailing Address - Fax:
Practice Address - Street 1:2 FERNALD STREET
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:ME
Practice Address - Zip Code:04294
Practice Address - Country:US
Practice Address - Phone:207-645-2896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC66401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2058262OtherCIGNA
ME122509OtherMAGELLAN BEHAVIORAL
ME047228OtherANTHEM
MEME0470Medicare ID - Type Unspecified