MEDICARE: JASMINE BROWN LAC

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	101YP2500X	Professional Counselor	LAC-23366	AZ

General Provider Information

NPI Number	:	1255847372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE BROWN LAC

Provider Business Mailing Address
First Line	:	6901 E CHAUNCEY LN APT 2081
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-5123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 E CHAUNCEY LN APT 2081
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85054-5123
Country	:	US
Telephone Number	:	678-460-0345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	05/01/2025

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Directions to “ JASMINE BROWN LAC” Practice Location

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