Provider Demographics
NPI:1598518904
Name:JEFFERS, LASHAE
Entity Type:Individual
Prefix:
First Name:LASHAE
Middle Name:
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3159 CARPENTERS PARK RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9223
Mailing Address - Country:US
Mailing Address - Phone:814-408-0014
Mailing Address - Fax:
Practice Address - Street 1:500 GALLERIA DR STE 164
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-8902
Practice Address - Country:US
Practice Address - Phone:814-408-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor