Healthcare Provider Details

I. General information

NPI: 1982308359
Provider Name (Legal Business Name): JASMINE PARKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 BETHELVIEW DR STE 500
CUMMING GA
30040-6913
US

IV. Provider business mailing address

1525 LAUREL CROSSING PKWY APT 301
BUFORD GA
30519-6569
US

V. Phone/Fax

Practice location:
  • Phone: 470-229-4013
  • Fax:
Mailing address:
  • Phone: 470-229-4013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC016553
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: