Provider Demographics
NPI:1285217554
Name:JENKINS, JASMINE (LGMFT)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LGMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ROLLING HILL WALK APT 202
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2458
Mailing Address - Country:US
Mailing Address - Phone:301-974-1708
Mailing Address - Fax:
Practice Address - Street 1:6440 DOBBIN RD STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4770
Practice Address - Country:US
Practice Address - Phone:410-730-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM820106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist