Provider Demographics
NPI:1386240067
Name:MALBREAUX, JASMINE (LPC)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MALBREAUX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CHESIRE COVE LN
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:AL
Mailing Address - Zip Code:35761-6200
Mailing Address - Country:US
Mailing Address - Phone:256-929-9921
Mailing Address - Fax:
Practice Address - Street 1:122 CHESIRE COVE LN
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:AL
Practice Address - Zip Code:35761-6200
Practice Address - Country:US
Practice Address - Phone:256-929-9921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC05453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional