Provider Demographics
NPI:1700535945
Name:JENKINS, JORDAN MARY (MSW, LCSW, OSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:MARY
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MSW, LCSW, OSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 S MINNESOTA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6455
Mailing Address - Country:US
Mailing Address - Phone:605-524-8910
Mailing Address - Fax:605-309-7851
Practice Address - Street 1:3508 S MINNESOTA AVE STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6455
Practice Address - Country:US
Practice Address - Phone:605-524-8910
Practice Address - Fax:605-309-7851
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD33871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty