Provider Demographics
NPI:1083667125
Name:HARLIN-CLIFTON, SHAWNA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MARIE
Last Name:HARLIN-CLIFTON
Suffix:
Gender:F
Credentials:LPC
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 1094
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-1094
Mailing Address - Country:US
Mailing Address - Phone:478-237-2484
Mailing Address - Fax:478-237-7541
Practice Address - Street 1:243 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3163
Practice Address - Country:US
Practice Address - Phone:478-237-2484
Practice Address - Fax:478-237-7541
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 003758101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC003758OtherSTATE LICENSE