Provider Demographics
NPI:1639498025
Name:SHIFFERT, JANA B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANA
Middle Name:B
Last Name:SHIFFERT
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 1:2449 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2559
Mailing Address - Country:US
Mailing Address - Phone:561-685-1617
Mailing Address - Fax:561-967-8076
Practice Address - Street 1:2449 WATERSIDE DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-2559
Practice Address - Country:US
Practice Address - Phone:561-685-1617
Practice Address - Fax:561-967-8076
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical