Provider Demographics
NPI:1720633878
Name:GARCIA, JASMIN CHANTEL (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:CHANTEL
Last Name:GARCIA
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 1:10902 CLERKENWELL ALY
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5536
Mailing Address - Country:US
Mailing Address - Phone:301-442-5053
Mailing Address - Fax:
Practice Address - Street 1:4502 SCHENLEY RD STE 100A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2524
Practice Address - Country:US
Practice Address - Phone:667-354-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24363104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker