Provider Demographics
NPI:1609916204
Name:CLIFFORD, JAMES W (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 GERARD AVE W
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1226
Mailing Address - Country:US
Mailing Address - Phone:516-225-9916
Mailing Address - Fax:718-869-8883
Practice Address - Street 1:145 BEACH 8TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5608
Practice Address - Country:US
Practice Address - Phone:718-869-8880
Practice Address - Fax:718-869-8883
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0298361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical