Healthcare Provider Details

I. General information

NPI: 1205464799
Provider Name (Legal Business Name): JASMINE R RAMIREZ-IBEABUCHI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TOWN SQUARE PL STE 1201
JERSEY CITY NJ
07310-1724
US

IV. Provider business mailing address

155 WARD PL
SOUTH ORANGE NJ
07079-2516
US

V. Phone/Fax

Practice location:
  • Phone: 917-620-3230
  • Fax:
Mailing address:
  • Phone: 917-620-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: