Provider Demographics
NPI:1326254236
Name:JAFFEE, ANDREA P (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:P
Last Name:JAFFEE
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 1:97 SAINT MARKS PL
Mailing Address - Street 2:APT #4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5111
Mailing Address - Country:US
Mailing Address - Phone:347-512-8187
Mailing Address - Fax:
Practice Address - Street 1:136 E 57TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2707
Practice Address - Country:US
Practice Address - Phone:212-935-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075316-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical