Healthcare Provider Details

I. General information

NPI: 1467396838
Provider Name (Legal Business Name): JAZZMIN T SADDLER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 RIDGEMONT DR
BIRMINGHAM AL
35244-1219
US

IV. Provider business mailing address

408 FAIRLAWN DR
STOCKBRIDGE GA
30281-7777
US

V. Phone/Fax

Practice location:
  • Phone: 404-216-7629
  • Fax:
Mailing address:
  • Phone: 404-216-7629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6688C
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW010271
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: