Provider Demographics
NPI:1891015418
Name:JENKINS, JAMES PERRY JR (MA, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PERRY
Last Name:JENKINS
Suffix:JR
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5170 HEATHERTON DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-7825
Mailing Address - Country:US
Mailing Address - Phone:318-470-0931
Mailing Address - Fax:318-658-9012
Practice Address - Street 1:5170 HEATHERTON DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-7825
Practice Address - Country:US
Practice Address - Phone:318-470-0931
Practice Address - Fax:318-658-9012
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-05
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA3671101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional