Provider Demographics
NPI:1033257969
Name:RATCLIFF, CONSTANCE B (MS T-LPC)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:B
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:MS T-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 OCOEE CIR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:TN
Mailing Address - Zip Code:37361-3632
Mailing Address - Country:US
Mailing Address - Phone:423-338-9434
Mailing Address - Fax:
Practice Address - Street 1:2292 CHAMBLISS AVE NW
Practice Address - Street 2:SUITE C-2
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3862
Practice Address - Country:US
Practice Address - Phone:423-479-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional