Provider Demographics
NPI:1104700624
Name:BURNS, JASMINE NICOLE (DBH, LPC, CRC)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:NICOLE
Last Name:BURNS
Suffix:
Gender:F
Credentials:DBH, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 CHESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3311
Mailing Address - Country:US
Mailing Address - Phone:205-614-3104
Mailing Address - Fax:
Practice Address - Street 1:1400 FREDA DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35228-3143
Practice Address - Country:US
Practice Address - Phone:205-835-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL225C00000X
ALLPC05697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor