Provider Demographics
NPI:1679910525
Name:RATCLIFF, LIANA MICHELLE (BCABA)
Entity type:Individual
Prefix:MS
First Name:LIANA
Middle Name:MICHELLE
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 E PICKWICK CIR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3855
Mailing Address - Country:US
Mailing Address - Phone:313-204-5507
Mailing Address - Fax:
Practice Address - Street 1:14799 DIX - TOLEDO
Practice Address - Street 2:TEAM MENTAL HEALTH SVCS
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195
Practice Address - Country:US
Practice Address - Phone:734-324-8326
Practice Address - Fax:734-324-8327
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 171400000X
MIL2431211171M00000X
MI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator