Provider Demographics
NPI:1225686082
Name:GAMBINO, JASMINE LEAH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:LEAH
Last Name:GAMBINO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12732 VEIRS MILL RD APT 204
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3561
Mailing Address - Country:US
Mailing Address - Phone:202-656-3045
Mailing Address - Fax:
Practice Address - Street 1:12732 VEIRS MILL RD APT 204
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3561
Practice Address - Country:US
Practice Address - Phone:202-656-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25283104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker