Provider Demographics
NPI:1215394606
Name:ANDERSON, JAYE L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAYE
Middle Name:L
Last Name:ANDERSON
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 1:2101 VISTA PKWY STE 254
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2706
Mailing Address - Country:US
Mailing Address - Phone:561-308-9818
Mailing Address - Fax:561-354-6035
Practice Address - Street 1:2101 VISTA PKWY STE 254
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-308-9818
Practice Address - Fax:561-354-6035
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW112801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical