Provider Demographics
NPI:1063667616
Name:JENKINS, CINDY C (LPC, MAC LAC)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:C
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPC, MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RUSKIN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-2522
Mailing Address - Country:US
Mailing Address - Phone:719-572-6150
Mailing Address - Fax:
Practice Address - Street 1:1852 IRWIN DR BLDG 1059
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80913-4176
Practice Address - Country:US
Practice Address - Phone:719-526-2062
Practice Address - Fax:719-526-8154
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD0000595101YA0400X
CO5076101YP2500X
COLPC0005076101YP2500X
CO6703101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional