Smith, Clifton
Smith, Clifton is an individual health care provider with primary practice located at 4645 Broadway , Gary IN 46409-2461. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Smith, Clifton can be contacted via phone (219) 981-2937.Contact Information
Primary practice address
4645 Broadway
Gary IN 46409-2461
Phone: (219) 981-2937
Fax: (219) 981-9273
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34001842A | Indiana |
Profile Details
| NPI number | 1417232414 |
|---|---|
| LBN Legal business name | Smith, Clifton |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2011 |
| Last updated | Oct 20th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417232414 | NPPES |
| Indiana | MEDICAID | 12104145 |
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