Provider Demographics
NPI:1083427959
Name:SMITHERMAN-JEFFERS, JACQUELINE (MHC-LP)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:SMITHERMAN-JEFFERS
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 BLEECKER ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1490
Mailing Address - Country:US
Mailing Address - Phone:718-635-1069
Mailing Address - Fax:
Practice Address - Street 1:159 BLEECKER ST APT 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1490
Practice Address - Country:US
Practice Address - Phone:718-635-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP133606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health