Healthcare Provider Details

I. General information

NPI: 1104700624
Provider Name (Legal Business Name): JASMINE NICOLE BURNS DBH, LPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FREDA DR
BIRMINGHAM AL
35228-3143
US

IV. Provider business mailing address

2214 CHESHIRE DR
BIRMINGHAM AL
35235-3311
US

V. Phone/Fax

Practice location:
  • Phone: 205-835-2970
  • Fax:
Mailing address:
  • Phone: 205-614-3104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC05697
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: