Provider Demographics
NPI:1952455974
Name:CLIFFORD, NAYA TRACY ELLEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NAYA
Middle Name:TRACY ELLEN
Last Name:CLIFFORD
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:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:ME
Mailing Address - Zip Code:04987-0038
Mailing Address - Country:US
Mailing Address - Phone:207-595-1030
Mailing Address - Fax:
Practice Address - Street 1:22 ARMORY ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6258
Practice Address - Country:US
Practice Address - Phone:207-595-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC110951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical