Healthcare Provider Details

I. General information

NPI: 1184815623
Provider Name (Legal Business Name): EMILIA JANINE RAMIREZ M.A., LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILIA JANINE CHACON M.A., LPCC

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SAN JOSE
LAGUNA NM
87026-5026
US

IV. Provider business mailing address

6231 NACIONAL RD NW
ALBUQUERQUE NM
87114-6175
US

V. Phone/Fax

Practice location:
  • Phone: 505-552-5666
  • Fax: 505-552-6387
Mailing address:
  • Phone: 505-967-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number03-115371-00-2
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: