Provider Demographics
NPI:1437046646
Name:BIFANO, JEREMY (MSW)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:BIFANO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 ESSEX ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5266
Mailing Address - Country:US
Mailing Address - Phone:978-979-0685
Mailing Address - Fax:
Practice Address - Street 1:50 DUNHAM RIDGE ROAD
Practice Address - Street 2:3200-3350
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1882
Practice Address - Country:US
Practice Address - Phone:978-600-0816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical