Individual
JASMINE TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CMHC, LCPC
Contact information
Practice address
2320 DRUSILLA LANE, SUITE A #1027, BATON ROUGE, LA 70809-2045
(225) 399-2085
Mailing address
PO BOX 42045, BATON ROUGE, LA 70835-2045
(337) 298-1326
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
LA
101YM0800X
Mental Health Counselor
Primary
7008
LA
101YP2500X
Professional Counselor
7008
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12892457-6004
LCPC
UT
01
—
CP5644-R
CMHC LICENSE
NV
Enumeration date
05/24/2017
Last updated
04/18/2024
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