Provider Demographics
NPI:1316688179
Name:RAMIREZ, NATHAN RAYMOND I (PSYD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:RAYMOND
Last Name:RAMIREZ
Suffix:I
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 DICKINSON DR APT 310
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6148
Mailing Address - Country:US
Mailing Address - Phone:559-741-5781
Mailing Address - Fax:
Practice Address - Street 1:3611 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3368
Practice Address - Country:US
Practice Address - Phone:502-909-0772
Practice Address - Fax:855-859-0123
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical