Provider Demographics
NPI:1538951207
Name:BURRELL, JASMINE VICTORIA (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:VICTORIA
Last Name:BURRELL
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 GLASSY CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4024
Mailing Address - Country:US
Mailing Address - Phone:804-238-2422
Mailing Address - Fax:
Practice Address - Street 1:4600 LIVINGSTON RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3136
Practice Address - Country:US
Practice Address - Phone:202-562-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200002634104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker