National Provider Identifier

Shane Clinton Jaynes, LCSWR

Shane Clinton Jaynes, LCSWR is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (607) 256-7639.

NPI 1770521155Ithaca, NYSocial Worker

Profile Overview

NPI
1770521155
Provider Type
Individual
Primary Specialty
Social Worker
Enumeration Date
June 04, 2006
Last Updated
September 08, 2008

Practice Location

  • 1481 Trumansburg RD
  • Ithaca, NY 14850

Phone: (607) 256-7639

Specialties

  • Social Worker (104100000X)
  • Social Worker (104100000X)
Full Record
NPI
1770521155
Entity Type
Individual
Last Name
Jaynes
First Name
Shane
Middle Name
Clinton
Name Prefix
Dr.
Credential
LCSWR
Mailing Street Address
1481 Trumansburg RD
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850
Mailing Country
US
Mailing Phone
(607) 256-7639
Practice Street Address
1481 Trumansburg RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 256-7639
Enumeration Date
June 04, 2006
Last Updated
September 08, 2008
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Social Worker (104100000X), Social Worker (104100000X)