Provider Demographics
NPI:1750132767
Name:COPE, JASMINE (LCSWA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:COPE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 TALICUD TRL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-9781
Mailing Address - Country:US
Mailing Address - Phone:919-604-4699
Mailing Address - Fax:
Practice Address - Street 1:113 TALICUD TRL
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-9781
Practice Address - Country:US
Practice Address - Phone:919-604-4699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0170331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical