Provider Demographics
NPI:1326385469
Name:BENN JASMINE, YETTIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:YETTIA
Middle Name:
Last Name:BENN JASMINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 STUMPF BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-382-9879
Mailing Address - Fax:
Practice Address - Street 1:1720 STUMPF BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056
Practice Address - Country:US
Practice Address - Phone:504-223-3140
Practice Address - Fax:504-910-9339
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2018-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA67951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical