Provider Demographics
NPI:1861624249
Name:RATNAM, BRIDGETTE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:BRIDGETTE
Middle Name:
Last Name:RATNAM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:BRIDGETTE
Other - Middle Name:
Other - Last Name:RATNAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:10015 OLD COLUMBIA RD STE B215
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1865
Mailing Address - Country:US
Mailing Address - Phone:240-593-1307
Mailing Address - Fax:
Practice Address - Street 1:1363 BECKNEL AVE
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1501
Practice Address - Country:US
Practice Address - Phone:240-593-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical