Provider Demographics
NPI:1194205013
Name:CARREIRA, JAE KIERSTIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAE
Middle Name:KIERSTIN
Last Name:CARREIRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4614 KATHI DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8701
Mailing Address - Country:US
Mailing Address - Phone:610-997-0927
Mailing Address - Fax:
Practice Address - Street 1:961 MARCON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9373
Practice Address - Country:US
Practice Address - Phone:610-823-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0235021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical