Provider Demographics
NPI:1952426405
Name:JEFFERS, JENNIFER A (LISW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23875 COMMERCE PARK
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5805
Mailing Address - Country:US
Mailing Address - Phone:216-464-5500
Mailing Address - Fax:216-378-8900
Practice Address - Street 1:23875 COMMERCE PARK
Practice Address - Street 2:SUITE 160
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5805
Practice Address - Country:US
Practice Address - Phone:216-464-5500
Practice Address - Fax:216-378-8900
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-75821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical