Basic Information
| Provider Information | |||||||||
| NPI: | 1831556216 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENKINS COUNSELING SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1513 LINE AVE STE 225 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711014621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187543890 | ||||||||
| FaxNumber: | 3186589012 | ||||||||
| Practice Location | |||||||||
| Address1: | 1513 LINE AVE STE 225 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711014621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187543890 | ||||||||
| FaxNumber: | 3186589012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2016 | ||||||||
| LastUpdateDate: | 01/13/2022 | ||||||||
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| AuthorizedOfficialLastName: | JENKINS | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | PERRY | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3184700931 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | LPC | ||||||||
| NPICertificationDate: | 01/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.