Provider Demographics
NPI:1588301378
Name:RAWCLIFFE, CHRISTIAN MARTIN I (LGSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:MARTIN
Last Name:RAWCLIFFE
Suffix:I
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 SERPENTINE WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-1110
Mailing Address - Country:US
Mailing Address - Phone:210-913-3445
Mailing Address - Fax:
Practice Address - Street 1:182 SERPENTINE WAY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-1110
Practice Address - Country:US
Practice Address - Phone:210-913-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00944812104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker