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Individual

JASMIN R FELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1 W COURT SQ, DECATUR, GA 30030-2538
(678) 590-1187
Mailing address
1415 KINGS POINT WAY SW, CONYERS, GA 30094-5793
(678) 590-1187

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005635
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003224827A
FL
Enumeration date
11/03/2015
Last updated
09/04/2020
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