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General NPI Number Information
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NPI Number | 1194343723
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Entity Type | Individual
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Provider Name | GILL WAYNE JASMINE JR. LPC
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Gender | Male
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 3801 NORTH BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70806-3825
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Country | US
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Telephone | 225-655-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 26579 OLD BARNWOOD DR
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-5901
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Country | US
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Telephone | 985-817-5705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8488
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License Number State | LA
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