Provider Demographics
NPI:1891974770
Name:JEFFERS, JILL ANN (MA, LSW)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:MA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2932
Mailing Address - Country:US
Mailing Address - Phone:508-373-7811
Mailing Address - Fax:
Practice Address - Street 1:535 LINCOLN ST # 286-292
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1910
Practice Address - Country:US
Practice Address - Phone:508-453-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health