Provider Demographics
NPI:1871037325
Name:JOHNSON, JASMINE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 WESTBANK EXPY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-4366
Mailing Address - Country:US
Mailing Address - Phone:504-832-5123
Mailing Address - Fax:
Practice Address - Street 1:1901 WESTBANK EXPY
Practice Address - Street 2:SUITE 550
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4366
Practice Address - Country:US
Practice Address - Phone:504-832-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician