Provider Demographics
NPI:1447655782
Name:RAMIREZ, JESUS (LPC, LSOTP)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 STARR RANCH #8301
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:78015
Mailing Address - Country:US
Mailing Address - Phone:830-431-3211
Mailing Address - Fax:
Practice Address - Street 1:222 SIDNEY BAKER SUITE 435
Practice Address - Street 2:
Practice Address - City:KERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-515-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional