Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jasmine Wayne

Individual provider Professional Counselor · NPI 1215578745

Jasmine Wayne is a Mental Health Counselor in Southfield, Michigan. Qualified in 2019, 7 years ago. Practices with Evolutionary Intervention LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2019
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Practice location Address checks out

17515 W 9 Mile Rd Ste 975
Southfield, MI 48075-4412
Phone: (248) 521-5051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401017725 (MI)

Record details

NPI number1215578745
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 7, 2019
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026
Mailing address17515 W 9 Mile Rd Ste 975, Southfield, MI 48075-4412

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Evolutionary Intervention Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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