Provider Demographics
NPI:1881926863
Name:ROLLINS, JENIVEVE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENIVEVE
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:OR
Mailing Address - Zip Code:97374-0482
Mailing Address - Country:US
Mailing Address - Phone:503-394-4294
Mailing Address - Fax:503-394-7096
Practice Address - Street 1:44644 CAMP MORRISON DR
Practice Address - Street 2:
Practice Address - City:SCIO
Practice Address - State:OR
Practice Address - Zip Code:97374-9336
Practice Address - Country:US
Practice Address - Phone:503-394-4294
Practice Address - Fax:503-394-7096
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL44141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical