Individual
HEATHER ANNE RADCLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW ACSW
Contact information
Practice address
65 PROFESSIONAL PL STE 102103, BRIDGEPORT, WV 26330-0258
(304) 848-5770
(304) 848-0980
Mailing address
65 PROFESSIONAL PL STE 102103, BRIDGEPORT, WV 26330-0258
(304) 848-5770
(304) 848-0980
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00941015
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649539396
—
WV
Enumeration date
05/15/2012
Last updated
09/07/2022
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