Provider Demographics
NPI:1376193730
Name:CLIFTON, EBONY (PHD, LPC)
Entity type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 HALSEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6813
Mailing Address - Country:US
Mailing Address - Phone:225-288-8440
Mailing Address - Fax:504-354-1318
Practice Address - Street 1:2609 HALSEY AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6813
Practice Address - Country:US
Practice Address - Phone:225-288-8440
Practice Address - Fax:504-354-1318
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8625101YP2500X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator