Provider Demographics
NPI:1003620022
Name:ALBERT, JAZMIN TASHAY
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:TASHAY
Last Name:ALBERT
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 1:125 S YEARLING RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1828
Mailing Address - Country:US
Mailing Address - Phone:380-710-1309
Mailing Address - Fax:
Practice Address - Street 1:125 S YEARLING RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-1828
Practice Address - Country:US
Practice Address - Phone:380-710-1309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-10-17
Deactivation Date:2025-03-26
Deactivation Code:
Reactivation Date:2025-10-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No171M00000XOther Service ProvidersCase Manager/Care Coordinator