Provider Demographics
NPI:1306009600
Name:JAFFE, MICHELE S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:S
Last Name:JAFFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:DIANE STEIN
Other - Last Name:JAFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1250 GREENWOOD AVE
Mailing Address - Street 2:APT 319 PLAZA APTS
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:267-481-2823
Mailing Address - Fax:
Practice Address - Street 1:25 CHATHAM DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2953
Practice Address - Country:US
Practice Address - Phone:267-481-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0150771041C0700X
NJ44SC059360001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical