Provider Demographics
NPI:1073852299
Name:JENKINS BOITNOTT, JENNIFER ELAINE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELAINE
Last Name:JENKINS BOITNOTT
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ELAINE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5318 PATTERSON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2044
Mailing Address - Country:US
Mailing Address - Phone:804-217-2202
Mailing Address - Fax:
Practice Address - Street 1:5318 PATTERSON AVE STE C
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2044
Practice Address - Country:US
Practice Address - Phone:804-217-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional