Provider Demographics
NPI:1902145824
Name:JEFFERY, ELIZABETH A (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:JEFFERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 CENTERPOINTE BLVD APT 7
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-7803
Mailing Address - Country:US
Mailing Address - Phone:607-368-9141
Mailing Address - Fax:
Practice Address - Street 1:7454 SENECA RD N
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-9141
Practice Address - Country:US
Practice Address - Phone:607-324-2483
Practice Address - Fax:607-324-3883
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0968641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical