Provider Demographics
NPI:1447965876
Name:MCKINNEY, JASMINE R (LPC)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:R
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45815 US HIGHWAY 280
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-6183
Mailing Address - Country:US
Mailing Address - Phone:256-626-0201
Mailing Address - Fax:
Practice Address - Street 1:45815 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-6183
Practice Address - Country:US
Practice Address - Phone:256-626-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health