Provider Demographics
NPI:1477766335
Name:LEIFER, JANE SHELLEY (LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:SHELLEY
Last Name:LEIFER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3782 PENDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2580
Mailing Address - Country:US
Mailing Address - Phone:703-716-7399
Mailing Address - Fax:
Practice Address - Street 1:3782 PENDERWOOD DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2580
Practice Address - Country:US
Practice Address - Phone:703-716-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD061161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical