Provider Demographics
NPI:1770304990
Name:RAMOS, LORI (MA, LCDC, CHW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MA, LCDC, CHW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3801 VIOLET RD APT 15
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-2947
Mailing Address - Country:US
Mailing Address - Phone:254-231-8106
Mailing Address - Fax:
Practice Address - Street 1:3801 VIOLET RD APT 15
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-2947
Practice Address - Country:US
Practice Address - Phone:254-231-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14620101YA0400X
TX18020172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)