Active NPI
Candace Marie Jeffries, L.C.S.W.
- Clinical Social Worker
- London, KY
National Provider Identifier
1689766644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3042
- Practice address
- 1675 S Main St
London, KY 40741-2050 - Phone
- (606) 878-1961
- Fax
- (606) 877-1958
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3042 | KY | Primary |
Addresses
Primary practice location
1675 S Main St
London, KY 40741-2050
Mailing address
151 Makenzie LN
London, KY 40744-9487
Phone (606) 878-2141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3042 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689766644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 MAKENZIE LN",
"city": "LONDON",
"state": "KY",
"postal_code": "407449487",
"telephone_number": "606-878-2141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 S MAIN ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407412050",
"telephone_number": "606-878-1961",
"fax_number": "606-877-1958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFRIES",
"first_name": "CANDACE",
"middle_name": "MARIE",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in London, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.