Provider Demographics
NPI:1972133650
Name:RATLIFF, PAUL PERKINS (MFT-LP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:PERKINS
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:MFT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PROSPECT PARK W APT 3E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4565
Mailing Address - Country:US
Mailing Address - Phone:347-225-1420
Mailing Address - Fax:
Practice Address - Street 1:156 5TH AVE STE 1223
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7735
Practice Address - Country:US
Practice Address - Phone:347-674-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP104196106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist