Provider Demographics
NPI:1346386331
Name:ORLOVICK, RALPH H (PHD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:H
Last Name:ORLOVICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S MERAMEC AVE
Mailing Address - Street 2:SUITE 932
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3511
Mailing Address - Country:US
Mailing Address - Phone:314-863-7141
Mailing Address - Fax:314-863-2114
Practice Address - Street 1:225 S MERAMEC AVE
Practice Address - Street 2:SUITE 932
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3511
Practice Address - Country:US
Practice Address - Phone:314-863-7141
Practice Address - Fax:314-863-2114
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPSY00778103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO70148Medicare ID - Type UnspecifiedPSYCHOLOGIST