# MR. CARL FREDERICK JEFFERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063546083
- **Gender:** Man
- **Credential:** C.A.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 372600000X | Adult Companion | — | NULL | Yes |
| 373H00000X | Day Training/Habilitation Specialist | — | NULL | — |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 04/02/2025