Provider Demographics
NPI:1801325071
Name:JEFFERS, YASMINE (LMFTA)
Entity type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 KENNYS ST
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-6447
Mailing Address - Country:US
Mailing Address - Phone:704-222-6610
Mailing Address - Fax:
Practice Address - Street 1:1818 LOMBARDY CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-6056
Practice Address - Country:US
Practice Address - Phone:704-412-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12031A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health