Provider Demographics
NPI:1578312914
Name:CRYSTAL CLIFFORD, LCSW PLLC
Entity type:Organization
Organization Name:CRYSTAL CLIFFORD, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-352-1020
Mailing Address - Street 1:375 HARMONY HILL RD
Mailing Address - Street 2:
Mailing Address - City:HARWINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06791-1417
Mailing Address - Country:US
Mailing Address - Phone:860-352-1020
Mailing Address - Fax:
Practice Address - Street 1:375 HARMONY HILL RD
Practice Address - Street 2:
Practice Address - City:HARWINTON
Practice Address - State:CT
Practice Address - Zip Code:06791-1417
Practice Address - Country:US
Practice Address - Phone:860-352-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty