Provider Demographics
NPI:1417705757
Name:CHEVANNES, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:CHEVANNES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W COURTYARD DR STE 2-225
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-5044
Mailing Address - Country:US
Mailing Address - Phone:512-956-5003
Mailing Address - Fax:512-233-0553
Practice Address - Street 1:6101 W COURTYARD DR STE 2-225
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-5044
Practice Address - Country:US
Practice Address - Phone:512-956-5003
Practice Address - Fax:512-233-0553
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional