Provider Demographics
NPI:1639824923
Name:JONES, JASMINE LEEANN (LMSW, CCM)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:LEEANN
Last Name:JONES
Suffix:
Gender:F
Credentials:LMSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 VETERANS PKWY APT 1215
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1962
Mailing Address - Country:US
Mailing Address - Phone:229-921-1931
Mailing Address - Fax:
Practice Address - Street 1:8160 VETERANS PKWY APT 1215
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-1962
Practice Address - Country:US
Practice Address - Phone:229-921-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5734G104100000X
4255234171M00000X
GAMSW010525104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty