Provider Demographics
NPI:1497564074
Name:STUKES, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:STUKES
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 1:969 E 89TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3910
Mailing Address - Country:US
Mailing Address - Phone:646-975-1911
Mailing Address - Fax:
Practice Address - Street 1:1441 BROADWAY FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-1879
Practice Address - Country:US
Practice Address - Phone:646-389-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health