Provider Demographics
NPI:1043442742
Name:JENKINSLPC, DORIS (LPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:JENKINSLPC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 DAWSON BRANCH ROAD
Mailing Address - Street 2:COVENANT COUNSELING
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483
Mailing Address - Country:US
Mailing Address - Phone:843-851-1806
Mailing Address - Fax:
Practice Address - Street 1:1851 DAWSON BRANCH ROAD
Practice Address - Street 2:COVENANT COUNSELING
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-851-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional