Individual provider Active NPI

Donald Ratliff Jr., LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1265921787
Registry record updated Feb 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
99085365A Issued in IN
Practice address
3333 N Illinois St
Indianapolis, IN 46208-4676
Phone
(317) 561-0421
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 99085365A IN Primary

Addresses

Primary practice location

3333 N Illinois St
Indianapolis, IN 46208-4676

Mailing address

4965 Potomac Square Way Unit 3
Indianapolis, IN 46268-5808
Phone (317) 561-0421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99085365AINMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582416000000",
    "number": "1265921787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 POTOMAC SQUARE WAY UNIT 3",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462685808",
            "telephone_number": "317-561-0421",
            "fax_number": "463-202-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N ILLINOIS ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084676",
            "telephone_number": "317-561-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "DONALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2020-02-23",
        "certification_date": "2020-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99085365A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.