Provider Demographics
NPI:1225533565
Name:LESLIE JENKINS, PHD, PLLC
Entity Type:Organization
Organization Name:LESLIE JENKINS, PHD, PLLC
Other - Org Name:ANOTHER LOOK PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-519-2577
Mailing Address - Street 1:8910 GREENEWAY COMMONS PL STE 201
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-4065
Mailing Address - Country:US
Mailing Address - Phone:502-822-6623
Mailing Address - Fax:502-996-8260
Practice Address - Street 1:8910 GREENEWAY COMMONS PL STE 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-4065
Practice Address - Country:US
Practice Address - Phone:502-822-6623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty