Provider Demographics
NPI:1720346208
Name:MEYERHOFF, JEFFREY ALBERT (MA, LSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALBERT
Last Name:MEYERHOFF
Suffix:
Gender:M
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 1:131 MOUNT AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5752
Mailing Address - Country:US
Mailing Address - Phone:617-491-2070
Mailing Address - Fax:
Practice Address - Street 1:131 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5752
Practice Address - Country:US
Practice Address - Phone:617-491-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310588101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor