Provider Demographics
NPI:1013607266
Name:LAWRENCE, JASMIN (MHC-LP)
Entity Type:Individual
Prefix:MS
First Name:JASMIN
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WORTHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-2309
Mailing Address - Country:US
Mailing Address - Phone:917-687-6679
Mailing Address - Fax:
Practice Address - Street 1:35 WORTHINGTON RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-2309
Practice Address - Country:US
Practice Address - Phone:917-687-6679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty