MEDICARE: MRS. TIFFANY RATCLIFF DAIL MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker	3995	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831231554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY RATCLIFF DAIL MSW, LCSW

Provider Business Mailing Address
First Line	:	961 BEASLEY ST STE 170
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4120
Country	:	US
Telephone Number	:	859-226-5022
Fax Number	:	859-226-5025

Provider Business Practice Location Address
First Line	:	961 BEASLEY ST STE 170
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4120
Country	:	US
Telephone Number	:	859-226-5022
Fax Number	:	859-226-5025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	05/02/2016

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