Provider Demographics
NPI:1063523827
Name:RAMIREZ, EZEQUIEL (LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:EZEQUIEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 WINDMILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7256
Mailing Address - Country:US
Mailing Address - Phone:325-944-7344
Mailing Address - Fax:325-947-9755
Practice Address - Street 1:2307 W HARRIS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3718
Practice Address - Country:US
Practice Address - Phone:325-947-7729
Practice Address - Fax:325-947-9755
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6190LCOtherBC/BS PROVIDER #