Provider Demographics
NPI:1063668655
Name:RAMIREZ, JACQUELINE CURRY (LPC, CACII)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:CURRY
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 ROSWELL RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4432
Mailing Address - Country:US
Mailing Address - Phone:404-372-7808
Mailing Address - Fax:404-842-0208
Practice Address - Street 1:3833 ROSWELL RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4432
Practice Address - Country:US
Practice Address - Phone:404-372-7808
Practice Address - Fax:404-842-0208
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1758101YA0400X
GALPC005327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1758OtherCERTIFIED ADDICTIONS COUNSELOR
GALPC005327OtherLICENSED PROFESSIONAL COUNSELOR