Healthcare Provider Details

I. General information

NPI: 1629930706
Provider Name (Legal Business Name): HOLLY R JASMIN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 HARVARD RD
SHIRLEY MA
01464-2439
US

IV. Provider business mailing address

35 PARKWOOD DR STE 205
HOPKINTON MA
01748-1727
US

V. Phone/Fax

Practice location:
  • Phone: 978-425-4341
  • Fax:
Mailing address:
  • Phone: 978-235-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: