Healthcare Provider Details
I. General information
NPI: 1144397654
Provider Name (Legal Business Name): WILLIAM CLIFFORD HAUGHN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/29/2006
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36 CORDAGE PARK CIR STE 123
PLYMOUTH MA
02360-7320
US
IV. Provider business mailing address
30 JACQUELINE LN
PLYMOUTH MA
02360-4672
US
V. Phone/Fax
- Phone: 508-927-6920
- Fax: 508-689-7695
- Phone: 508-746-9049
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: