Provider Demographics
NPI:1891947644
Name:ST. JOHN, JASMINE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:
Last Name:ST. JOHN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 S YELLOWSTONE DR
Mailing Address - Street 2:#209
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2902
Mailing Address - Country:US
Mailing Address - Phone:608-279-3900
Mailing Address - Fax:
Practice Address - Street 1:437 S YELLOWSTONE DR
Practice Address - Street 2:#209
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2902
Practice Address - Country:US
Practice Address - Phone:608-279-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI788-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist