Provider Demographics
NPI:1912554510
Name:JEFFREY D. KAYE, LCSW
Entity Type:Organization
Organization Name:JEFFREY D. KAYE, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER OF SOCIAL WOR
Authorized Official - Phone:760-686-3768
Mailing Address - Street 1:19320 TEWA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-5158
Mailing Address - Country:US
Mailing Address - Phone:760-686-3768
Mailing Address - Fax:
Practice Address - Street 1:18484 OUTER HWY 18 STE 125
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2371
Practice Address - Country:US
Practice Address - Phone:760-686-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty