Provider Demographics
NPI:1992560460
Name:CERBIN, JAZLYN M (LCSW)
Entity type:Individual
Prefix:
First Name:JAZLYN
Middle Name:M
Last Name:CERBIN
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 1:132 SHERMAN ST APT 9
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3218
Mailing Address - Country:US
Mailing Address - Phone:718-877-4367
Mailing Address - Fax:
Practice Address - Street 1:132 SHERMAN ST APT 9
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-3218
Practice Address - Country:US
Practice Address - Phone:718-877-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230184104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker