Provider Demographics
NPI:1700582400
Name:JENKINS, NANCY JAN (MA, LPC, PLPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JAN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MA, LPC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705B SE MELODY LN # 151
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4390
Mailing Address - Country:US
Mailing Address - Phone:913-709-0229
Mailing Address - Fax:
Practice Address - Street 1:7255 W 98TH TER STE 154
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2200
Practice Address - Country:US
Practice Address - Phone:816-974-7378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional