Provider Demographics
NPI:1982933552
Name:RATCLIFF, STEPHEN (MA, LPCC, LPC, NCC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:RATCLIFF
Suffix:
Gender:M
Credentials:MA, LPCC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3258
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-0821
Mailing Address - Country:US
Mailing Address - Phone:505-504-5449
Mailing Address - Fax:
Practice Address - Street 1:120 ALISO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2693
Practice Address - Country:US
Practice Address - Phone:505-504-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0144871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC6334OtherLICENSED PROFESSIONAL COUNSELOR (LPC
NM0144871OtherLICENSED CLINICAL MENTAL HEALTH COUNSELOR (LPCC)
NM15804321Medicaid