Provider Demographics
NPI:1144604521
Name:LAMOTTA, CLIFFORD (LMSW)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:
Last Name:LAMOTTA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 KEELER DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-1009
Mailing Address - Country:US
Mailing Address - Phone:203-209-4684
Mailing Address - Fax:
Practice Address - Street 1:123 KEELER DR
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-1009
Practice Address - Country:US
Practice Address - Phone:203-209-4684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTTBD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical