Provider Demographics
NPI:1194042754
Name:RATCLIFF, LEW (LCPC)
Entity Type:Individual
Prefix:MR
First Name:LEW
Middle Name:
Last Name:RATCLIFF
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 GRASSY RD
Mailing Address - Street 2:
Mailing Address - City:MAKANDA
Mailing Address - State:IL
Mailing Address - Zip Code:62958-5133
Mailing Address - Country:US
Mailing Address - Phone:618-997-5336
Mailing Address - Fax:618-993-2969
Practice Address - Street 1:1307 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1139
Practice Address - Country:US
Practice Address - Phone:618-997-5336
Practice Address - Fax:618-993-2969
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.005968101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional