Provider Demographics
NPI:1639806938
Name:RATCLIFFE, JACQUI (LMSW, CRADC)
Entity Type:Individual
Prefix:
First Name:JACQUI
Middle Name:
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:LMSW, CRADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 E SANDPIPER DR
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-4264
Mailing Address - Country:US
Mailing Address - Phone:417-827-7007
Mailing Address - Fax:
Practice Address - Street 1:10944 STATE HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737
Practice Address - Country:US
Practice Address - Phone:417-527-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO220220194221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty