Provider Demographics
NPI:1881140895
Name:WOODS, JASMINE NICOLE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:NICOLE
Last Name:WOODS
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 1:1165 N MILWAUKEE AVE
Mailing Address - Street 2:APT 2509
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-4098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1165 N MILWAUKEE AVE
Practice Address - Street 2:APT 2509
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-4098
Practice Address - Country:US
Practice Address - Phone:773-398-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health