Healthcare Provider Details

I. General information

NPI: 1558285643
Provider Name (Legal Business Name): JASMINE ALLEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 CYPRESS VILLAGE BLVD STE B
RUSKIN FL
33573-6831
US

IV. Provider business mailing address

926 CYPRESS VILLAGE BLVD STE B
RUSKIN FL
33573-6831
US

V. Phone/Fax

Practice location:
  • Phone: 813-819-5271
  • Fax: 813-819-5272
Mailing address:
  • Phone: 813-819-5271
  • Fax: 813-819-5272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: