Provider Demographics
NPI:1568756732
Name:JENKINS, KENYA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1468 NESTLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2846
Mailing Address - Country:US
Mailing Address - Phone:202-706-7586
Mailing Address - Fax:855-239-2220
Practice Address - Street 1:1468 NESTLEWOOD CT
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2846
Practice Address - Country:US
Practice Address - Phone:202-706-7586
Practice Address - Fax:855-239-2220
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health