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General NPI Number Information
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NPI Number | 1316688179
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Entity Type | Individual
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Provider Name | NATHAN RAYMOND RAMIREZ I PSYD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 3611 NEWBURG RD
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City | LOUISVILLE
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State | KY
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Zip | 40218-3368
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Country | US
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Telephone | 502-909-0772
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Fax | 855-859-0123
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Provider Business Mailing Address
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Address Line | 8205 DICKINSON DR APT 310
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City | LOUISVILLE
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State | KY
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Zip | 40241-6148
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Country | US
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Telephone | 559-741-5781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS020417
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License Number State | PA
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