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1649519190 NPI number — MICCA NICHOLE RATLIFF M.ED, LPCC, NCC

NPI Number: 1649519190
Health Care Provider/Practitioner: MICCA NICHOLE RATLIFF M.ED, LPCC, NCC

Information about “1649519190” NPI (MICCA NICHOLE RATLIFF M.ED, LPCC, NCC) exists in 1649519190 in HTML format HTML  |  1649519190 in plain Text format TXT  |  1649519190 in PDF (Portable Document Format) PDF  |  1649519190 in an XML format XML  formats.

NPI Number : 1649519190 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649519190",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RATLIFF",
    "FirstName": "MICCA",
    "MiddleName": "NICHOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.ED, LPCC, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5666 KY ROUTE 850",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HIPPO",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "41653-8334",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "606-358-9520",
    "MailingAddressFaxNumber": "606-886-0055",
    "FirstLinePracticeLocationAddress": "113 OAK RIDGE CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PRESTONSBURG",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "41653-8607",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-889-1602",
    "PracticeLocationAddressFaxNumber": "606-263-4467",
    "EnumerationDate": "02/04/2013",
    "LastUpdateDate": "04/26/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "2288",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "E.2102246",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "1458",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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