Provider Demographics
NPI:1679655286
Name:RAMOS, VIRGINIA MARIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:MARIA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:MI
Mailing Address - Zip Code:49327-7900
Mailing Address - Country:US
Mailing Address - Phone:231-834-0444
Mailing Address - Fax:231-834-0200
Practice Address - Street 1:1615 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:MI
Practice Address - Zip Code:49304-7984
Practice Address - Country:US
Practice Address - Phone:231-745-2743
Practice Address - Fax:231-745-5031
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087926101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1712452Medicaid
MI750910902Medicare UPIN
MI90378Medicare UPIN
MI20366Medicare UPIN
MI750910482Medicare UPIN
MI750910903Medicare UPIN
MI750910910Medicare UPIN
MI1712452Medicaid
MIOP22320Medicare ID - Type Unspecified
MI20386Medicare UPIN
MI750910904Medicare UPIN