Basic Information
| Provider Information | |||||||||
| NPI: | 1043557168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JENKINS | ||||||||
| FirstName: | SHERRI | ||||||||
| MiddleName: | LEH | ||||||||
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| Credential: | LPC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 SAPPHIRE CT STE 110 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278349079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528307561 | ||||||||
| FaxNumber: | 2527520074 | ||||||||
| Practice Location | |||||||||
| Address1: | 2808 S CROATAN HWY STE B | ||||||||
| Address2: | |||||||||
| City: | NAGS HEAD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279599024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524412324 | ||||||||
| FaxNumber: | 2524411994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2013 | ||||||||
| LastUpdateDate: | 01/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | A9856 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.