Provider Demographics
NPI:1184061467
Name:RAMIREZ, MIKE A (CADCINTERN)
Entity type:Individual
Prefix:MR
First Name:MIKE
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:CADCINTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9513
Mailing Address - Country:US
Mailing Address - Phone:775-954-1400
Mailing Address - Fax:775-954-1406
Practice Address - Street 1:888 W 2ND ST
Practice Address - Street 2:SUITE 205
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5626
Practice Address - Country:US
Practice Address - Phone:775-333-7877
Practice Address - Fax:775-333-7874
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00482-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)