Provider Demographics
NPI:1841997970
Name:YANDOC, JASMINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:YANDOC
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 WHEATLEY DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4146
Mailing Address - Country:US
Mailing Address - Phone:443-786-8287
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD STE 350
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7126
Practice Address - Country:US
Practice Address - Phone:443-955-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29485104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker