Provider Demographics
NPI:1114461480
Name:CLIFTON, HOWARD BLAIN (PLPC)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:BLAIN
Last Name:CLIFTON
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:MR
Other - First Name:HOWARD
Other - Middle Name:BLAIN
Other - Last Name:CLIFTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PLPC
Mailing Address - Street 1:107 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-2311
Mailing Address - Country:US
Mailing Address - Phone:318-368-4755
Mailing Address - Fax:318-982-8050
Practice Address - Street 1:107 MILLER ST
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241
Practice Address - Country:US
Practice Address - Phone:318-368-4755
Practice Address - Fax:318-982-8050
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LAPLC-10092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator