Healthcare Provider Details

I. General information

NPI: 1548183882
Provider Name (Legal Business Name): AUTUMN MARIE CLIFTON BSW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4270 IVY POINTE BLVD
CINCINNATI OH
45245-0003
US

IV. Provider business mailing address

145 WYNDCREST CT APT B
MONROE OH
45050-1788
US

V. Phone/Fax

Practice location:
  • Phone: 513-833-0553
  • Fax:
Mailing address:
  • Phone: 513-806-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: