Provider Demographics
NPI:1346601648
Name:GENUS, JASMINE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:GENUS
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 1:13017 WISTERIA DR # 245
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2621
Mailing Address - Country:US
Mailing Address - Phone:619-456-7714
Mailing Address - Fax:
Practice Address - Street 1:16220 FREDERICK RD STE 502
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4022
Practice Address - Country:US
Practice Address - Phone:301-978-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW761391041C0700X, 1041C0700X
DCLC500809711041C0700X, 1041C0700X
MD194871041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical