Provider Demographics
NPI:1679839484
Name:JEFFERY, WILLIAM LYONS (MHC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LYONS
Last Name:JEFFERY
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OHARA DR
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-2046
Mailing Address - Country:US
Mailing Address - Phone:607-334-8244
Mailing Address - Fax:607-336-5779
Practice Address - Street 1:3 OHARA DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-2046
Practice Address - Country:US
Practice Address - Phone:607-334-8244
Practice Address - Fax:607-336-5779
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18P82976101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health