Provider Demographics
NPI:1962955278
Name:CEPEDA, JASMINE (LCSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 JAVA ST STE 304
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-5599
Mailing Address - Country:US
Mailing Address - Phone:347-699-4867
Mailing Address - Fax:
Practice Address - Street 1:252 JAVA ST STE 304
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5599
Practice Address - Country:US
Practice Address - Phone:347-699-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0887391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical