Provider Demographics
NPI:1386379014
Name:RAMOS, JOE III (LPC)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:RAMOS
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:FORREST
Mailing Address - State:IL
Mailing Address - Zip Code:61741-9376
Mailing Address - Country:US
Mailing Address - Phone:779-237-0429
Mailing Address - Fax:
Practice Address - Street 1:622 N PEARL ST
Practice Address - Street 2:
Practice Address - City:FORREST
Practice Address - State:IL
Practice Address - Zip Code:61741-9376
Practice Address - Country:US
Practice Address - Phone:779-237-0429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015383101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional