Provider Demographics
NPI:1629684824
Name:COLVIN, JASMINE RUFFIN (LICSW)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:RUFFIN
Last Name:COLVIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:DENISE
Other - Last Name:RUFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1302 GARDENS PL
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-6158
Mailing Address - Country:US
Mailing Address - Phone:937-581-7960
Mailing Address - Fax:
Practice Address - Street 1:3701 LOOP RD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5015
Practice Address - Country:US
Practice Address - Phone:205-554-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4244C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical