MEDICARE: RAMIR WOODARD LCSWA, LCASA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P021312	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-30812	NC

General Provider Information

NPI Number	:	1093524126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMIR WOODARD LCSWA, LCASA

Provider Business Mailing Address
First Line	:	3125 POPLARWOOD CT STE 203
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-6445
Country	:	US
Telephone Number	:	919-787-6131
Fax Number	:	919-571-2932

Provider Business Practice Location Address
First Line	:	3117 POPLARWOOD CT STE 115
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1040
Country	:	US
Telephone Number	:	919-787-6131
Fax Number	:	919-571-2932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2025
Last Update Date	:	12/01/2025

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