Provider Demographics
NPI:1356873566
Name:RAMOS, MARDIA (LMHC)
Entity type:Individual
Prefix:
First Name:MARDIA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5690
Mailing Address - Country:US
Mailing Address - Phone:305-510-7381
Mailing Address - Fax:
Practice Address - Street 1:3761 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5690
Practice Address - Country:US
Practice Address - Phone:305-510-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH15781101YM0800X
FLMH16856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health