| Brenda Jaffe, Lcsw-c, Llc | |
|
100 Bourbon St Havre De Grace MD 21078-3147 | |
| (410) 939-9339 | |
| (410) 497-1104 |
| Full Name | Brenda Jaffe, Lcsw-c, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Bourbon St, Havre De Grace, Maryland |
| Authorized Official Name and Position | Brenda H.g. Jaffe (PROPRIETOR, THERAPIST) |
| Authorized Official Contact | 3022421028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda Jaffe, Lcsw-c, Llc Po Box 835 Havre De Grace MD 21078-0835 Ph: (302) 242-1028 | Brenda Jaffe, Lcsw-c, Llc 100 Bourbon St Havre De Grace MD 21078-3147 Ph: (410) 939-9339 |
| NPI Number | 1760785521 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 12/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760785521 | NPI | - | NPPES |
| 15O4O3701 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 13482 (Maryland) | Primary |
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