Provider Demographics
NPI:1477920981
Name:SEARCY, JASMIN (PHD)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:SEARCY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JASMIN
Other - Middle Name:SHENELLE
Other - Last Name:SEARCY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6501 S PROMONTORY DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1002
Mailing Address - Country:US
Mailing Address - Phone:773-256-5724
Mailing Address - Fax:
Practice Address - Street 1:1276 N CLYBOURN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2089
Practice Address - Country:US
Practice Address - Phone:312-337-1073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009593103TC2200X, 103TH0004X
WY598103TC2200X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent