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NPI Code Detail

MEDICARE: DR. JASMINE LACHELLE COHEN-YOUNG LSCSW

MEDICARE: DR. JASMINE LACHELLE COHEN-YOUNG LSCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker05347KS
21041C0700XClinical Social WorkerCSW007279GA
3104100000XSocial Worker05347KS

General Provider Information

NPI Number : 1114493210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASMINE LACHELLE COHEN-YOUNG LSCSW
Provider Business Mailing Address
First Line : 5501 ABERCORN STREET
Second Line : UNIT 5 - #102
City : SAVANNAH
State : GA
Zip : 31405
Country : US
Telephone Number : 762-901-2297
Fax Number :
Provider Business Practice Location Address
First Line : 650 HUEBNER RD
Second Line :
City : FORT RILEY
State : KS
Zip : 66442-4030
Country : US
Telephone Number : 785-239-7000
Fax Number : 630-570-5779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 04/09/2026

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