Provider Demographics
NPI:1659344323
Name:RATLIFF, LESLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 MAIN ST
Mailing Address - Street 2:SUITE 108 A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3612
Mailing Address - Country:US
Mailing Address - Phone:615-226-2929
Mailing Address - Fax:615-226-2929
Practice Address - Street 1:953 MAIN ST
Practice Address - Street 2:SUITE 108 A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3612
Practice Address - Country:US
Practice Address - Phone:615-226-2929
Practice Address - Fax:615-226-2929
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3013623OtherBLUE CROSS BLUE SHIELD
TN3695854Medicare ID - Type Unspecified