Provider Demographics
NPI:1356034029
Name:BARNES, JASMINE (MSW, MPH, LSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSW, MPH, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 S DANTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-6511
Mailing Address - Country:US
Mailing Address - Phone:312-771-7384
Mailing Address - Fax:
Practice Address - Street 1:8423 S DANTE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-6511
Practice Address - Country:US
Practice Address - Phone:312-771-7384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1090011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical