Provider Demographics
NPI:1982400297
Name:JEFFERSON, JOCELYNN
Entity type:Individual
Prefix:
First Name:JOCELYNN
Middle Name:
Last Name:JEFFERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9083 STATE HIGHWAY 276
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-6405
Mailing Address - Country:US
Mailing Address - Phone:214-701-5295
Mailing Address - Fax:
Practice Address - Street 1:9083 STATE HIGHWAY 276
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-6405
Practice Address - Country:US
Practice Address - Phone:214-701-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health