Provider Demographics
NPI:1881215796
Name:BISHOP-LONDY, JASMIN
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:BISHOP-LONDY
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 1:1185 SALEM ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4639
Mailing Address - Country:US
Mailing Address - Phone:617-459-1083
Mailing Address - Fax:
Practice Address - Street 1:84 HIGH ST STE 3
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3844
Practice Address - Country:US
Practice Address - Phone:781-395-0828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical