Provider Demographics
NPI:1477066397
Name:JENKINS, JOE LEE
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:LEE
Last Name:JENKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:LEE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC - S LIC # 62961
Mailing Address - Street 1:6327 DIAMOND ROCK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4220
Mailing Address - Country:US
Mailing Address - Phone:832-418-9524
Mailing Address - Fax:281-861-9524
Practice Address - Street 1:3455 SARAH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-2906
Practice Address - Country:US
Practice Address - Phone:713-942-8100
Practice Address - Fax:713-533-1408
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional