Provider Demographics
NPI:1962599639
Name:RATLIFF, COURTNEY JENEA (LMSW)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:JENEA
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W CANTEY ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1402
Mailing Address - Country:US
Mailing Address - Phone:817-723-9034
Mailing Address - Fax:
Practice Address - Street 1:6707 BRENTWOOD STAIR RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-3335
Practice Address - Country:US
Practice Address - Phone:817-446-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker