Provider Demographics
NPI:1992250401
Name:KIEFFNER, ABIGAIL JOSEPHINE (LCSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JOSEPHINE
Last Name:KIEFFNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:HUTTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 769
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-0769
Mailing Address - Country:US
Mailing Address - Phone:812-482-3020
Mailing Address - Fax:812-482-6409
Practice Address - Street 1:480 EVERSMAN DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3548
Practice Address - Country:US
Practice Address - Phone:812-482-3020
Practice Address - Fax:812-482-6409
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99074705A104100000X
IN34008990A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker