Provider Demographics
NPI:1336288158
Name:JENKINS, DENISE DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:DIANE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E DEBBIE LN STE 105
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2955
Mailing Address - Country:US
Mailing Address - Phone:817-313-3348
Mailing Address - Fax:
Practice Address - Street 1:751 E DEBBIE LN STE 105
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2955
Practice Address - Country:US
Practice Address - Phone:817-313-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical