Healthcare Provider Details

I. General information

NPI: 1982255931
Provider Name (Legal Business Name): LUIS DANIEL RAMIREZ PH.D., DSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2019
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5649 ROME NEW LONDON RD
ROME NY
13440-8336
US

IV. Provider business mailing address

5649 ROME NEW LONDON RD
ROME NY
13440-8336
US

V. Phone/Fax

Practice location:
  • Phone: 315-520-0859
  • Fax: 315-281-8213
Mailing address:
  • Phone: 315-520-0859
  • Fax: 315-281-8213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094815
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: