Provider Demographics
NPI:1912789041
Name:WALKER, JASMIN CAMILA (LSW)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:CAMILA
Last Name:WALKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1665
Mailing Address - Country:US
Mailing Address - Phone:732-208-4672
Mailing Address - Fax:
Practice Address - Street 1:2 BENNINGTON PL
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5701
Practice Address - Country:US
Practice Address - Phone:732-309-1679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06564200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker