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General NPI Number Information
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NPI Number | 1477035319
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Entity Type | Individual
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Provider Name | JASMEKA MONAE WILSON LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 780 FISHERMAN ST
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City | OPA LOCKA
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State | FL
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Zip | 33054-3806
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Country | US
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Telephone | 786-398-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 18135 NW 25TH CT
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3632
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Country | US
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Telephone | 786-398-1511
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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 | 101YM0800X
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Taxonomy Name | Mental Health 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 | 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 #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3543
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License Number State | FL
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