Provider Demographics
NPI:1922359884
Name:RAMOS, JENNIFER JENINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JENINE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:JENINE
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCSW
Mailing Address - Street 1:21097 W MINNEZONA AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-1128
Mailing Address - Country:US
Mailing Address - Phone:917-681-0524
Mailing Address - Fax:
Practice Address - Street 1:21097 W MINNEZONA AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-1128
Practice Address - Country:US
Practice Address - Phone:917-681-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078631-1104100000X
AZLCSW-202691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker