Individual
SHANIECE T JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTER
Contact information
Practice address
220 HEBERTON AVE, STATEN ISLAND, NY 10302-1415
(718) 448-1900
(718) 448-1901
Mailing address
495 HENDRIX ST APT 3A, BROOKLYN, NY 11207-4341
(347) 955-7886
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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