Provider Demographics
NPI:1902793342
Name:LONG, CLIFFORD DARNELL JR (LSW)
Entity type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:DARNELL
Last Name:LONG
Suffix:JR
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-3506
Mailing Address - Country:US
Mailing Address - Phone:609-491-1781
Mailing Address - Fax:
Practice Address - Street 1:39 E MAIN ST STE 302
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2154
Practice Address - Country:US
Practice Address - Phone:856-409-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL071708001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical