Provider Demographics
NPI:1255594578
Name:CLIFFORD, PATRICIA A (NCC, LCPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16013 PHEASANT RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8447
Mailing Address - Country:US
Mailing Address - Phone:301-520-0065
Mailing Address - Fax:
Practice Address - Street 1:16013 PHEASANT RIDGE CT
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797-8447
Practice Address - Country:US
Practice Address - Phone:301-520-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2818101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional