MEDICARE: JASMINE BARNES MSW, MPH, LSW

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	1041C0700X	Clinical Social Worker	150.109001	IL

General Provider Information

NPI Number	:	1356034029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE BARNES MSW, MPH, LSW

Provider Business Mailing Address
First Line	:	8423 S DANTE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-6511
Country	:	US
Telephone Number	:	312-771-7384
Fax Number	:

Provider Business Practice Location Address
First Line	:	8423 S DANTE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-6511
Country	:	US
Telephone Number	:	312-771-7384
Fax Number	:

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

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	05/30/2023

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