Provider Demographics
NPI:1568956944
Name:ALLI, JASMINE (BSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:ALLI
Suffix:
Gender:F
Credentials:BSW, LSW
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:BEACHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW, LSW
Mailing Address - Street 1:238 S MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-2925
Mailing Address - Country:US
Mailing Address - Phone:330-318-3436
Mailing Address - Fax:
Practice Address - Street 1:3620 STUTZ DR
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9176
Practice Address - Country:US
Practice Address - Phone:330-286-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1802112104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker