Provider Demographics
NPI:1740654789
Name:JENKINS, CHRISTY (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23751 HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-8505
Mailing Address - Country:US
Mailing Address - Phone:712-792-9266
Mailing Address - Fax:712-792-1457
Practice Address - Street 1:23751 HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-8505
Practice Address - Country:US
Practice Address - Phone:712-792-9266
Practice Address - Fax:712-792-1457
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health