Provider Demographics
NPI:1831324672
Name:JENKINS, GOLDEN K (MDIV, MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:GOLDEN
Middle Name:K
Last Name:JENKINS
Suffix:
Gender:M
Credentials:MDIV, MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S ROSS ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5534
Mailing Address - Country:US
Mailing Address - Phone:334-444-3500
Mailing Address - Fax:334-821-8241
Practice Address - Street 1:120 S ROSS ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5534
Practice Address - Country:US
Practice Address - Phone:334-444-3500
Practice Address - Fax:334-821-8241
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional