Provider Demographics
NPI:1063706471
Name:COOPER, JASMINE ELIZABETH (MS, LCPC,NCC, LCADC)
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:ELIZABETH
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS, LCPC,NCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E FLAMINGO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5280
Mailing Address - Country:US
Mailing Address - Phone:702-498-3377
Mailing Address - Fax:
Practice Address - Street 1:1640 E FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5280
Practice Address - Country:US
Practice Address - Phone:702-498-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00167-LC101YA0400X
NV216-S101YM0800X
NV269823101Y00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator