Healthcare Provider Details

I. General information

NPI: 1467605121
Provider Name (Legal Business Name): JILL J RAMIREZ MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL J. WILLIAMSON MA, LMHC

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 GRIEGOS, N.W.
ALBUQUERQUE NM
87107
US

IV. Provider business mailing address

P.O. BOX 6485 1218 GRIEGOS, N.W.
ALBUQUERQUE NM
87107
US

V. Phone/Fax

Practice location:
  • Phone: 505-345-8471
  • Fax: 505-342-5414
Mailing address:
  • Phone: 505-345-8471
  • Fax: 505-342-5414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-0117401
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: