MEDICARE: MELISSA RAMIREZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	39167	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184856080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA RAMIREZ LCSW

Provider Business Mailing Address
First Line	:	3351 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	210-539-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 SCHOFIELD RD
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-7577
Country	:	US
Telephone Number	:	210-365-7168
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2009
Last Update Date	:	09/23/2022

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