Provider Demographics
NPI:1497327811
Name:TOWNSEND, JASMINE (LCSWA)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13435 STEELECROFT PKWY APT 103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7582
Mailing Address - Country:US
Mailing Address - Phone:757-894-2023
Mailing Address - Fax:
Practice Address - Street 1:13435 STEELECROFT PKWY APT 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7582
Practice Address - Country:US
Practice Address - Phone:757-894-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0154301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical