Provider Demographics
NPI:1376186510
Name:RATCLIFF, MICHELLE RANDALYN (MSS, DMFT, LSW)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:RANDALYN
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:MSS, DMFT, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BEAUMIN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2237
Mailing Address - Country:US
Mailing Address - Phone:267-259-2344
Mailing Address - Fax:
Practice Address - Street 1:105 BEAUMIN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2237
Practice Address - Country:US
Practice Address - Phone:267-259-2344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135596104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker