Provider Demographics
NPI:1972301695
Name:THOMPSON, JASMINE D (LSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:D
Last Name:THOMPSON
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 CEDAR LN APT C4
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1785
Mailing Address - Country:US
Mailing Address - Phone:201-655-2247
Mailing Address - Fax:
Practice Address - Street 1:611 CEDAR LN APT C4
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1785
Practice Address - Country:US
Practice Address - Phone:201-655-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL0705574001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical