Provider Demographics
NPI:1568204006
Name:WILSON, RAMSEY (LMSW-CC)
Entity type:Individual
Prefix:
First Name:RAMSEY
Middle Name:
Last Name:WILSON
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RAILROAD SQ STE 1
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6139
Mailing Address - Country:US
Mailing Address - Phone:207-699-9513
Mailing Address - Fax:
Practice Address - Street 1:57 SPRUCE ST APT 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3745
Practice Address - Country:US
Practice Address - Phone:207-699-9513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC214041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical