Provider Demographics
NPI:1720633423
Name:RAGLAND, RICHETTE MARIE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:RICHETTE
Middle Name:MARIE
Last Name:RAGLAND
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:RICHETTE
Other - Middle Name:MARIE
Other - Last Name:FLETCHER-RAGLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:802 BALTIMORE PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4212
Mailing Address - Country:US
Mailing Address - Phone:410-874-0711
Mailing Address - Fax:
Practice Address - Street 1:802 BALTIMORE PIKE STE A
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4212
Practice Address - Country:US
Practice Address - Phone:410-874-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3162101YP2500X
CALC3162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional