Provider Demographics
NPI:1093518508
Name:RAWLS, JASMINE (LMHC)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:RAWLS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12316 KENTBROOK MANOR LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-3937
Mailing Address - Country:US
Mailing Address - Phone:253-720-1616
Mailing Address - Fax:253-720-1616
Practice Address - Street 1:2470 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6403
Practice Address - Country:US
Practice Address - Phone:813-586-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24033101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health