Provider Demographics
NPI:1184075632
Name:RATLIFF, DEBRA (LPCC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 PLAZA DR
Mailing Address - Street 2:STE D
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-2062
Mailing Address - Country:US
Mailing Address - Phone:859-200-2107
Mailing Address - Fax:
Practice Address - Street 1:1002 BROOKLYN BLVD
Practice Address - Street 2:APT 2
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1091
Practice Address - Country:US
Practice Address - Phone:859-200-2107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1184101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY81-3649251OtherEMPLOYER IDENTIFICATION NUMBER: