Healthcare Provider Details

I. General information

NPI: 1295463560
Provider Name (Legal Business Name): RACHEL ELENA LORENZO-RAMIREZ LMHC, NCC, CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3418 91ST ST APT C12
JACKSON HEIGHTS NY
11372-3626
US

IV. Provider business mailing address

3418 91ST ST APT C12
JACKSON HEIGHTS NY
11372-3626
US

V. Phone/Fax

Practice location:
  • Phone: 347-870-3149
  • Fax:
Mailing address:
  • Phone: 803-868-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number007572
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: