Provider Demographics
NPI:1093217556
Name:JAFFEE, REBECCA F (LCSWR)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:F
Last Name:JAFFEE
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STONY BROOK CT STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-6522
Mailing Address - Country:US
Mailing Address - Phone:845-565-0400
Mailing Address - Fax:866-733-1910
Practice Address - Street 1:400 STONY BROOK CT STE 1
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-6522
Practice Address - Country:US
Practice Address - Phone:845-565-0400
Practice Address - Fax:866-733-1910
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079725-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical