Provider Demographics
NPI:1215766035
Name:JEFFERS, SPRING L (TLLP, LLC)
Entity type:Individual
Prefix:
First Name:SPRING
Middle Name:L
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:TLLP, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38335 HIXFORD PL
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3396
Mailing Address - Country:US
Mailing Address - Phone:734-968-8501
Mailing Address - Fax:
Practice Address - Street 1:41550 E ANN ARBOR TRL
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4308
Practice Address - Country:US
Practice Address - Phone:734-207-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103TC1900X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling