Provider Demographics
NPI:1245807775
Name:BAILEY, JASMINE R (LCPC)
Entity type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:R
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:ROCHELLE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19933 SWEETGUM CIR APT 11
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3787
Mailing Address - Country:US
Mailing Address - Phone:703-517-6330
Mailing Address - Fax:
Practice Address - Street 1:19933 SWEETGUM CIR APT 11
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-3787
Practice Address - Country:US
Practice Address - Phone:703-517-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC15887101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor