Provider Demographics
NPI:1942818901
Name:JENKINS, SARAH (RCSWI)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8553 J R MANOR DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1051
Mailing Address - Country:US
Mailing Address - Phone:727-550-6446
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY STE 164
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2049
Practice Address - Country:US
Practice Address - Phone:813-693-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW13911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health