Provider Demographics
NPI:1811597982
Name:AUSTIN, JASMINE MARIE (LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:MARIE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 AARONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4232
Mailing Address - Country:US
Mailing Address - Phone:615-429-4685
Mailing Address - Fax:
Practice Address - Street 1:1405 W BADDOUR PKWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2567
Practice Address - Country:US
Practice Address - Phone:615-994-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5233101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health