Provider Demographics
NPI:1225802119
Name:CLIFFORD, MELISSA (MS, NCC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 N 12TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1225
Mailing Address - Country:US
Mailing Address - Phone:717-620-9867
Mailing Address - Fax:
Practice Address - Street 1:635 N 12TH ST STE 101
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1225
Practice Address - Country:US
Practice Address - Phone:717-585-0627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health