Provider Demographics
NPI:1235747981
Name:LABORDE, JEFFICA
Entity Type:Individual
Prefix:
First Name:JEFFICA
Middle Name:
Last Name:LABORDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEFFICA
Other - Middle Name:
Other - Last Name:CHERISIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:720 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2917
Mailing Address - Country:US
Mailing Address - Phone:516-787-1103
Mailing Address - Fax:
Practice Address - Street 1:119 SCHENECTADY AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2330
Practice Address - Country:US
Practice Address - Phone:347-915-1113
Practice Address - Fax:347-915-1113
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYJT-562699104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker