Provider Demographics
NPI:1013447531
Name:LEFEVRE, JEFF (RSW)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:LEFEVRE
Suffix:
Gender:M
Credentials:RSW
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:LEFEVRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RSW
Mailing Address - Street 1:406 W MORRIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-4150
Mailing Address - Country:US
Mailing Address - Phone:985-402-3698
Mailing Address - Fax:985-402-3699
Practice Address - Street 1:406 W MORRIS AVE STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-402-3698
Practice Address - Fax:985-402-3698
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13979101YM0800X
LA101YM0800X, 171M00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health