Healthcare Provider Details

I. General information

NPI: 1053258095
Provider Name (Legal Business Name): CHRISTOPHER BLANCO-RAMOS LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DYER ST FL 2
PROVIDENCE RI
02903-3927
US

IV. Provider business mailing address

30 EASTBROOK RD STE 101
DEDHAM MA
02026-2083
US

V. Phone/Fax

Practice location:
  • Phone: 857-293-5020
  • Fax: 857-226-8772
Mailing address:
  • Phone: 857-293-5020
  • Fax: 857-226-8772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01940
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: