Provider Demographics
NPI:1346642279
Name:JASKI, KRISTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:JASKI
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 1:127 ABERCORN ST STE 301B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4069
Mailing Address - Country:US
Mailing Address - Phone:917-405-9640
Mailing Address - Fax:
Practice Address - Street 1:127 ABERCORN ST, SUITE 301B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401
Practice Address - Country:US
Practice Address - Phone:917-405-9640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ054825001041C0700X
GACSW00647781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical