Provider Demographics
NPI:1003782426
Name:ATHENA JENKINS LLC
Entity type:Organization
Organization Name:ATHENA JENKINS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/RN
Authorized Official - Phone:203-494-3916
Mailing Address - Street 1:6 LAKE COURT UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517
Mailing Address - Country:US
Mailing Address - Phone:203-494-3916
Mailing Address - Fax:
Practice Address - Street 1:6 LAKE COURT UNIT 2
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517
Practice Address - Country:US
Practice Address - Phone:203-494-3916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health