Basic Information
| Provider Information | |||||||||
| NPI: | 1659970390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MAGGIE A CLIFFORD COUNSELING , PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8443 LAVENHAM | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782542465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108978750 | ||||||||
| FaxNumber: | 8334781412 | ||||||||
| Practice Location | |||||||||
| Address1: | 18834 STONE OAK PKWY STE 104 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108978750 | ||||||||
| FaxNumber: | 8334781412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2020 | ||||||||
| LastUpdateDate: | 03/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | CLIFFORD | ||||||||
| AuthorizedOfficialFirstName: | MAGGIE | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | LICENSED CLINICAL SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 2108978750 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 03/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.