Provider Demographics
NPI:1518780469
Name:CLIFTON, JOY
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:KOUTS
Mailing Address - State:IN
Mailing Address - Zip Code:46347-9405
Mailing Address - Country:US
Mailing Address - Phone:813-716-8203
Mailing Address - Fax:
Practice Address - Street 1:714 SUNSET DR
Practice Address - Street 2:
Practice Address - City:KOUTS
Practice Address - State:IN
Practice Address - Zip Code:46347-9405
Practice Address - Country:US
Practice Address - Phone:813-716-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13880101YM0800X
IN39004518A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health