Provider Demographics
NPI:1700538618
Name:RAMIREZ, AMANDA (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CORAM AVENUE
Mailing Address - Street 2:APARTMENT 200
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484
Mailing Address - Country:US
Mailing Address - Phone:203-727-6520
Mailing Address - Fax:
Practice Address - Street 1:275 CORAM AVENUE
Practice Address - Street 2:APARTMENT 200
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484
Practice Address - Country:US
Practice Address - Phone:203-727-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional