Provider Demographics
NPI:1982705265
Name:RAMSDEN, RALPH DARRELL (PHD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:DARRELL
Last Name:RAMSDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1535
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-1535
Mailing Address - Country:US
Mailing Address - Phone:276-676-1177
Mailing Address - Fax:276-676-1027
Practice Address - Street 1:845 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-4414
Practice Address - Country:US
Practice Address - Phone:276-676-1177
Practice Address - Fax:276-676-1027
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
166765OtherVALUE OPTIONS
VA240200OtherANTHEM BLUE CROSS BLUE SH
VA007706405Medicaid
VA680001102Medicare PIN