Provider Demographics
NPI:1528740362
Name:RAMIREZ, TANYA D (LPC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:D
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3208
Mailing Address - Country:US
Mailing Address - Phone:414-581-2536
Mailing Address - Fax:
Practice Address - Street 1:N19W24101 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53188-1109
Practice Address - Country:US
Practice Address - Phone:844-453-2053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11505-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional