Individual
DR. CLINTON B STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW PHD
Contact information
Practice address
523 TOWNLINE RD, SUITE 9, HAUPPAUGE, NY 11788
(631) 265-0505
Mailing address
9 BROOKSITE DRIVE, SMITHTOWN, NY 11787
(631) 265-0060
(631) 265-0757
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
037435
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7401979
VALUE OPTIONS
NY
01
—
P2717816
OXFORD
NY
Enumeration date
02/09/2007
Last updated
07/08/2007
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