Provider Demographics
NPI:1861374951
Name:RAMOS, LEONARDO IV
Entity type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:RAMOS
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1323
Mailing Address - Country:US
Mailing Address - Phone:219-292-6813
Mailing Address - Fax:
Practice Address - Street 1:2005 VALPARAISO ST STE 209
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3331
Practice Address - Country:US
Practice Address - Phone:219-252-5464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health