Provider Demographics
NPI:1285764258
Name:RAMOS, ELIZABETH ANNE (MSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:DEILKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5306
Mailing Address - Country:US
Mailing Address - Phone:910-484-0176
Mailing Address - Fax:910-484-5781
Practice Address - Street 1:805 WESTMONT DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-4555
Practice Address - Country:US
Practice Address - Phone:910-484-4061
Practice Address - Fax:910-485-4069
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1169101YA0400X
NCC0074241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC145XNOtherBCBS
NC199701OtherMEDCOST
NC6111965Medicaid