Provider Demographics
NPI:1750020285
Name:JENKINS, ALEXIS (MS, MFT)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W TABOR RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2819
Mailing Address - Country:US
Mailing Address - Phone:215-321-3918
Mailing Address - Fax:
Practice Address - Street 1:19 S MAIN ST STE B2-1
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1510
Practice Address - Country:US
Practice Address - Phone:215-321-3918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist