Provider Demographics
NPI:1902470560
Name:WINTER, JASMINE ASH (LMSW, LCSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:ASH
Last Name:WINTER
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15511 95TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2156
Mailing Address - Country:US
Mailing Address - Phone:314-213-0794
Mailing Address - Fax:
Practice Address - Street 1:15511 95TH AVE
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2156
Practice Address - Country:US
Practice Address - Phone:314-213-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230431131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490096197Medicaid
MO2021028781OtherLMSW