Provider Demographics
NPI:1144766171
Name:LU, JASMINE MEDSKER (MSSW)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MEDSKER
Last Name:LU
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:MEDSKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 HAVEN AVE APT 25F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-0576
Mailing Address - Country:US
Mailing Address - Phone:801-941-3355
Mailing Address - Fax:
Practice Address - Street 1:60 HAVEN AVE APT 25F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:801-941-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-14
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor