Healthcare Provider Details

I. General information

NPI: 1013629955
Provider Name (Legal Business Name): JASAMINE HARRINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 10/28/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ATLANTIC ST SW
WASHINGTON DC
20032-2350
US

IV. Provider business mailing address

1001 CASLON WAY APT 101
HYATTSVILLE MD
20785-5982
US

V. Phone/Fax

Practice location:
  • Phone: 202-407-7747
  • Fax:
Mailing address:
  • Phone: 901-679-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003472
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: