Healthcare Provider Details

I. General information

NPI: 1679720122
Provider Name (Legal Business Name): JESSICA N. JARMON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST SUITE 220A
PHILADELPHIA PA
19107-4216
US

IV. Provider business mailing address

925 CHESTNUT ST SUITE 220A
PHILADELPHIA PA
19107-4216
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-9313
  • Fax: 215-955-2010
Mailing address:
  • Phone: 215-955-9313
  • Fax: 215-955-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013856
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: