| Doctor Name: | MR. CLIFFORD WALTER CHURCHILL |
| NPI Number: | 1417196346 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | MH10577 |
| Business Practice Address: | 8625 Se Alabama Pl Cliffchurchilljr@gmail.com Hobe Sound, FL - 33455 |
| Business Phone Number: | 7724858828 |
| Business Fax Number: | 8564418421 |
| Mailing Address: | 2440 Se Federal Hwy, Suite L STUART |
| State: | FL |
| Postal Code: | 349944531 |
| Phone Number: | 7724858828 |
| Fax Number: | 8564418421 |
| NPI Enumeration Date: | 02/17/2009 |
| NPI Last Update Date: | 01/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH10577 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |