Provider Demographics
NPI:1386785376
Name:KIEFFER, JOAN B (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:B
Last Name:KIEFFER
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 1:8895 N MILITARY TRAIL, STE 300C
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6279
Mailing Address - Country:US
Mailing Address - Phone:615-244-9499
Mailing Address - Fax:561-345-3800
Practice Address - Street 1:5205 GREENWOOD AVE STE 105
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2400
Practice Address - Country:US
Practice Address - Phone:561-244-9499
Practice Address - Fax:561-345-3800
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW73561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108158200Medicaid