Provider Demographics
NPI:1699339945
Name:THOMAS, JASMINE (LPC, NCC)
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 S LINDEN RD STE 259
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5462
Mailing Address - Country:US
Mailing Address - Phone:810-449-0205
Mailing Address - Fax:
Practice Address - Street 1:2503 S LINDEN RD STE 259
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5462
Practice Address - Country:US
Practice Address - Phone:810-449-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016752101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor