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NPI Code Detail

MEDICARE: JASMINE SAMUEL

MEDICARE: JASMINE SAMUEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
21041C0700XClinical Social Worker
3106S00000XBehavior Technician

General Provider Information

NPI Number : 1366193815
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE SAMUEL
Provider Business Mailing Address
First Line : 2808 WINDSORVIEW DR
Second Line :
City : RICHMOND
State : VA
Zip : 23225-1826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1518 WILLOW LAWN DR
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3419
Country : US
Telephone Number : 804-370-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2022
Last Update Date : 02/09/2026

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Directions to “ JASMINE SAMUEL ” Practice Location

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