Provider Demographics
NPI:1942854021
Name:BRIDGETTE RATNAM, LLC
Entity Type:Organization
Organization Name:BRIDGETTE RATNAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-C
Authorized Official - Phone:240-593-1307
Mailing Address - Street 1:10015 OLD COLUMBIA RD STE B215
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1865
Mailing Address - Country:US
Mailing Address - Phone:240-593-1307
Mailing Address - Fax:
Practice Address - Street 1:10015 OLD COLUMBIA RD STE B215
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1865
Practice Address - Country:US
Practice Address - Phone:240-593-1307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health