Provider Demographics
NPI:1265921787
Name:RATLIFF, DONALD JR (LMHC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:RATLIFF
Suffix:JR
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4965 POTOMAC SQUARE WAY UNIT 3
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5808
Mailing Address - Country:US
Mailing Address - Phone:317-561-0421
Mailing Address - Fax:463-202-2109
Practice Address - Street 1:3333 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4676
Practice Address - Country:US
Practice Address - Phone:317-561-0421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99085365A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health