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General NPI Number Information
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NPI Number | 1922516822
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Entity Type | Individual
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Provider Name | JASMINE LUSTER LPC
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Gender | Female
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Dates
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Enumeration Date | 01/14/2018
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Last Update Date | 01/14/2018
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Provider Practice Location Address
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Address Line | 1499 LYNWOOD DR STE C
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City | LANCASTER
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State | SC
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Zip | 29720-0964
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Country | US
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Telephone | 843-376-1806
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Fax | 888-552-1363
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Provider Business Mailing Address
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Address Line | PO BOX 61237
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City | RALEIGH
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State | NC
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Zip | 27661-1237
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Country | US
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Telephone | 843-376-1806
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Fax | 888-552-1363
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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 | 6747
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License Number State | SC
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Taxonomy #2
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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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