Provider Demographics
NPI:1205399748
Name:WILLIAMS, JASMINE MARIE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 JADE CT
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1862
Mailing Address - Country:US
Mailing Address - Phone:518-955-4044
Mailing Address - Fax:
Practice Address - Street 1:6800 JADE CT
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-1862
Practice Address - Country:US
Practice Address - Phone:518-955-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105632104100000X
MD250681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker