Provider Demographics
NPI:1154195881
Name:NELSON, JASMYNE EVETTE (LCSW)
Entity type:Individual
Prefix:
First Name:JASMYNE
Middle Name:EVETTE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 UNION ST STE 545
Mailing Address - Street 2:PMB 914689
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-1876
Mailing Address - Country:US
Mailing Address - Phone:615-393-2653
Mailing Address - Fax:
Practice Address - Street 1:2615 MEDICAL CENTER PKWY STE 1560
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3758
Practice Address - Country:US
Practice Address - Phone:615-393-2653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88811041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical