Provider Demographics
NPI:1568719375
Name:CLIFFEL, LAUREN GWENETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:GWENETTE
Last Name:CLIFFEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20118 INDIAN ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3483
Mailing Address - Country:US
Mailing Address - Phone:813-468-8751
Mailing Address - Fax:
Practice Address - Street 1:6801 S DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33621-5129
Practice Address - Country:US
Practice Address - Phone:813-828-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW108561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical