MR. TYSON BENJAMIN RATZLAFF (NPI# 1376875377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376875377 |
| Entity Type | Individual |
| Full Name | MR. TYSON BENJAMIN RATZLAFF |
| Credential | LPC |
| Practice Address |
705 W Main St Tishomingo OK 73460-1734 |
| Mailing Address |
2355 E Cedar Ridge Rd Tishomingo OK 73460-4045 |
| Practice Telephone | 5803713799 |
| Mailing Telephone | 5802728012 |
| Mailing Fax Number | 5803712056 |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
4255 | OK | Behavioral Health & Social Service Providers |
| Street Address |
705 W MAIN ST |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460-1734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033490412 | Stephynne Dawn Stevens | Rehabilitation Counselor | 705 W Main St, Tishomingo, OK 73460-1734 | 2011-08-30 |
| 1962799593 | Pennington Creek Lifehouse | Case Management | 705 W Main St, Tishomingo, OK 73460-1734 | 2011-07-04 |
| 1023334836 | Jayne Hull | Counselor | 705 W Main St, Tishomingo, OK 73460-1734 | 2010-04-19 |
| 1558692137 | Daniel Floyd James | Counselor | 705 W Main St, Tishomingo, OK 73460-1734 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1720417652 | Candice Oliver | Counselor | 202 South Broadway B2, Tishomingo, OK 73406 | 2013-11-01 |
| 1386083988 | Danielle Ophellia Brown | Counselor | 605 E 8th, Tishomingo, OK 73460-2351 | 2013-06-18 |
| 1124462825 | Ronald Ray Hart | Counselor | 1303 E Cheadle Rd, Tishomingo, OK 73460-4205 | 2013-04-24 |
| 1508115791 | Steve Devol Cheadle | Counselor | 304 S Muldrow St, Tishomingo, OK 73460-2733 | 2012-09-03 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1083919179 | Teresa Wilie Kennison | Counselor | 1350 S Muldrow St, Tishomingo, OK 73460-3278 | 2011-01-20 |
| 1952628612 | Shanna Hobbs | Counselor | 608 East 24th, Tishomingo, OK 73460 | 2010-04-21 |
| 1417273483 | Lacy Anne Borengasser | Counselor | 705 W Main, Pennington Creek Lifehouse, Tishomingo, OK 73460 | 2010-04-15 |
| Find all providers in TISHOMINGO | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
Please comment or provide details below to improve the information on MR. TYSON BENJAMIN RATZLAFF.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.