Provider Demographics
NPI:1740751411
Name:JENKINS, LAUREN KAY
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KAY
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 1:735 WEST DR
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-3410
Mailing Address - Country:US
Mailing Address - Phone:985-312-2525
Mailing Address - Fax:337-221-1425
Practice Address - Street 1:735 WEST DR
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-3410
Practice Address - Country:US
Practice Address - Phone:985-312-2525
Practice Address - Fax:337-221-1425
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health