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General NPI Number Information
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NPI Number | 1356347231
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Entity Type | Individual
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Provider Name | JEFFERY ALLEN KAUFFMAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 E 20TH ST
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City | HOPE
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State | AR
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Zip | 71801-8217
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Country | US
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Telephone | 870-777-9051
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Fax | 870-777-3104
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Provider Business Mailing Address
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Address Line | 2904 ARKANSAS BLVD
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City | TEXARKANA
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State | AR
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Zip | 71854-2536
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Country | US
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Telephone | 870-773-4655
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Fax | 870-772-4650
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-1098
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27104
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License Number State | TX
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