Provider Demographics
NPI:1619677002
Name:FRAZIER, JASMINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PRESTON LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6853
Mailing Address - Country:US
Mailing Address - Phone:470-503-7087
Mailing Address - Fax:
Practice Address - Street 1:410 PRESTON LANDING CIR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-6853
Practice Address - Country:US
Practice Address - Phone:470-503-7087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010734104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker