Provider Demographics
NPI:1295469575
Name:JEFFERS, ASHLEE DANIELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:DANIELLE
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 GIBBONS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2724
Mailing Address - Country:US
Mailing Address - Phone:443-386-5805
Mailing Address - Fax:
Practice Address - Street 1:3617 GIBBONS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2724
Practice Address - Country:US
Practice Address - Phone:443-386-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28748104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker