Provider Demographics
NPI:1891896577
Name:JEFFRIES, LYNNE BARR (LCSW BCD)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:BARR
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:ELLEN
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:4068 MT ROYAL BLVD
Mailing Address - Street 2:GAMMA BUILDING SUITE 110
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101
Mailing Address - Country:US
Mailing Address - Phone:412-492-2021
Mailing Address - Fax:412-492-2010
Practice Address - Street 1:4068 MT ROYAL BLVD
Practice Address - Street 2:GAMMA BUILDING SUITE 110
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101
Practice Address - Country:US
Practice Address - Phone:412-492-2021
Practice Address - Fax:412-492-2010
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0126121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034694OtherCIGNA
PA116505OtherVALUE OPTIONS
PA1437418OtherHIGHMARK BCBS
PA180643OtherMENTAL HEALTH NET
PA116505OtherVALUE OPTIONS
PAQ15369Medicare UPIN