Provider Demographics
NPI:1649093550
Name:RAMER, LISA KRISTEN (LPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KRISTEN
Last Name:RAMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 LAMONT CIR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4539
Mailing Address - Country:US
Mailing Address - Phone:678-787-6213
Mailing Address - Fax:
Practice Address - Street 1:155 TECHNOLOGY PKWY STE 400
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2969
Practice Address - Country:US
Practice Address - Phone:678-787-6213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health