Kirsten Diedre Ann Jeffers, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

095838 Issued in NY

Practice address

6539 Anthony Dr Ste a
Victor, NY 14564-1441

Phone

(585) 398-8835

Fax

(585) 398-7376

NPI assigned

Jun 3, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1013575281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WITTER AVE",
            "city": "WELLSVILLE",
            "state": "NY",
            "postal_code": "148951331",
            "telephone_number": "585-610-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6539 ANTHONY DR STE A",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641441",
            "telephone_number": "585-398-8835",
            "fax_number": "585-398-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Witter Ave",
            "address_purpose": "LOCATION",
            "city": "Wellsville",
            "state": "NY",
            "postal_code": "148951331",
            "country_code": "US",
            "telephone_number": "585-610-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "KIRSTEN",
        "middle_name": "DIEDRE ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "095838",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LC20849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Victor, NY
• Providers in Victor, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.