Provider Demographics
NPI:1689059875
Name:HUSBAND, JAMIE (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:FAIRLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2720 PALMER DR APT J1
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-2854
Mailing Address - Country:US
Mailing Address - Phone:202-550-2273
Mailing Address - Fax:
Practice Address - Street 1:2720 PALMER DR APT J1
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-2854
Practice Address - Country:US
Practice Address - Phone:202-550-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW616857081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical