Provider Demographics
NPI:1417408253
Name:JEFFRIES, AMY ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:MASEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:618 BARWICK PL
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:MO
Mailing Address - Zip Code:65781
Mailing Address - Country:US
Mailing Address - Phone:402-499-6357
Mailing Address - Fax:866-520-5586
Practice Address - Street 1:406 COLLEGE ST # 2
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MO
Practice Address - Zip Code:65661-1346
Practice Address - Country:US
Practice Address - Phone:417-637-1476
Practice Address - Fax:866-520-5586
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016031774101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional