Provider Demographics
NPI:1578561148
Name:JENKINS, RITA VIRGINIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:VIRGINIA
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76503-0416
Mailing Address - Country:US
Mailing Address - Phone:254-774-8806
Mailing Address - Fax:254-774-9672
Practice Address - Street 1:200 W CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-3127
Practice Address - Country:US
Practice Address - Phone:254-774-8806
Practice Address - Fax:254-774-9672
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4899101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83954LOtherBCBS OF TEXAS