Provider Demographics
NPI:1003567744
Name:JEFFRIES, THERESA MICHELE (MSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MICHELE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 UNION ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9601
Mailing Address - Country:US
Mailing Address - Phone:724-797-4529
Mailing Address - Fax:724-379-1452
Practice Address - Street 1:800 PLAZA DR STE 270
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012-4020
Practice Address - Country:US
Practice Address - Phone:724-258-1226
Practice Address - Fax:724-379-1452
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker