Provider Demographics
NPI:1124027289
Name:JENKINS, SHARON RAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:RAE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 WEST LOOP S
Mailing Address - Street 2:STE 675 A
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2402
Mailing Address - Country:US
Mailing Address - Phone:281-414-6350
Mailing Address - Fax:281-988-6758
Practice Address - Street 1:5909 WEST LOOP S
Practice Address - Street 2:STE 675 A
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2402
Practice Address - Country:US
Practice Address - Phone:281-414-6350
Practice Address - Fax:281-988-6758
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 04719101YP2500X
TXLMFT 000635-41239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist