Healthcare Provider Details

I. General information

NPI: 1104491513
Provider Name (Legal Business Name): LYDIA ANNE RAMHARACK MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S CHURCH ST
WEST CHESTER PA
19382-3386
US

IV. Provider business mailing address

2231 GRAYS FERRY AVE SIDE 2
PHILADELPHIA PA
19146-1197
US

V. Phone/Fax

Practice location:
  • Phone: 817-584-0813
  • Fax:
Mailing address:
  • Phone: 215-964-8086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC017130
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: