Provider Demographics
NPI:1578147070
Name:JENKINS, VERONICA (MS, RMHCI)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13923 FELIX WILL RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-2414
Mailing Address - Country:US
Mailing Address - Phone:813-204-0560
Mailing Address - Fax:
Practice Address - Street 1:410 S WARE BLVD STE 805
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4456
Practice Address - Country:US
Practice Address - Phone:813-204-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health