Provider Demographics
NPI:1922826759
Name:AYERS, JEFFREY ALAN (EDS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:AYERS
Suffix:
Gender:M
Credentials:EDS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6593 COUNTY ROAD 424
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-6837
Mailing Address - Country:US
Mailing Address - Phone:573-220-8340
Mailing Address - Fax:
Practice Address - Street 1:5687 COUNTY ROAD 4010
Practice Address - Street 2:
Practice Address - City:TEBBETTS
Practice Address - State:MO
Practice Address - Zip Code:65080-1611
Practice Address - Country:US
Practice Address - Phone:573-220-8340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019025509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional