Provider Demographics
NPI:1881820264
Name:JAFFA, MIRIAM (LMSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:JAFFA
Suffix:
Gender:F
Credentials:LMSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 L ST NW STE 245
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1547
Mailing Address - Country:US
Mailing Address - Phone:248-227-0826
Mailing Address - Fax:
Practice Address - Street 1:2120 L ST NW STE 245
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1547
Practice Address - Country:US
Practice Address - Phone:248-227-0826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-30
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010899801041C0700X
DCLC2000022141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical