Provider Demographics
NPI:1336698570
Name:LEWIS, JASMINE CAPRI
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:CAPRI
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NICHOLS DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:70443-4770
Mailing Address - Country:US
Mailing Address - Phone:985-474-9728
Mailing Address - Fax:
Practice Address - Street 1:50 NICHOLS DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:LA
Practice Address - Zip Code:70443-4770
Practice Address - Country:US
Practice Address - Phone:985-474-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health