Provider Demographics
NPI:1508966383
Name:RATIGAN, ADRIENNE (MS)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:RATIGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-1419
Mailing Address - Country:US
Mailing Address - Phone:518-523-8785
Mailing Address - Fax:
Practice Address - Street 1:7513 COURT STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-873-3670
Practice Address - Fax:518-873-3777
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000419-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health