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NPI Code Detail

MEDICARE: JASMINE WADKINS LCSW

MEDICARE: JASMINE WADKINS LCSW
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 Worker
21041C0700XClinical Social Worker256292KY

General Provider Information

NPI Number : 1578867958
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE WADKINS LCSW
Provider Business Mailing Address
First Line : 101 W MUHAMAMD ALI BLVD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-1451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 633 BAXTER AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1157
Country : US
Telephone Number : 502-309-2408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2010
Last Update Date : 10/15/2024

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