Provider Demographics
NPI:1649608878
Name:CLIFFORD, AMBER (LCSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
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 1:405 HOUSTON CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE HAYNE
Mailing Address - State:NC
Mailing Address - Zip Code:28429-5489
Mailing Address - Country:US
Mailing Address - Phone:910-448-1082
Mailing Address - Fax:
Practice Address - Street 1:5710 OLEANDER DR STE 108
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4723
Practice Address - Country:US
Practice Address - Phone:910-448-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0085621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical