Provider Demographics
NPI:1124539127
Name:MAING, JASMIN V (LLMSW)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:V
Last Name:MAING
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-9234
Mailing Address - Country:US
Mailing Address - Phone:734-323-7334
Mailing Address - Fax:
Practice Address - Street 1:6700 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2039
Practice Address - Country:US
Practice Address - Phone:734-629-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801099507104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker