Provider Demographics
NPI:1184128696
Name:AYERS, JASMINE (LCSW-A)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 HEWITT ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2055
Mailing Address - Country:US
Mailing Address - Phone:919-222-9028
Mailing Address - Fax:
Practice Address - Street 1:307 BEECH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2818
Practice Address - Country:US
Practice Address - Phone:919-731-2119
Practice Address - Fax:919-739-4989
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0122661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical