Healthcare Provider Details

I. General information

NPI: 1336964592
Provider Name (Legal Business Name): SAMANTHA RAMOS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 BETA DR STE 108
MAYFIELD VILLAGE OH
44143-2335
US

IV. Provider business mailing address

17893 SAGAMORE RD
WALTON HILLS OH
44146-5160
US

V. Phone/Fax

Practice location:
  • Phone: 440-460-0140
  • Fax: 440-460-5413
Mailing address:
  • Phone: 216-832-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2507579
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: