Healthcare Provider Details

I. General information

NPI: 1619442316
Provider Name (Legal Business Name): ALICE RATLIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 PARK RD
FREEBURN KY
41528-8718
US

IV. Provider business mailing address

1709 KY ROUTE 321 STE 3
PRESTONSBURG KY
41653-9097
US

V. Phone/Fax

Practice location:
  • Phone: 606-984-5484
  • Fax: 877-447-0814
Mailing address:
  • Phone: 606-886-8546
  • Fax: 606-886-8548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001690
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: