Provider Demographics
NPI:1952917551
Name:JENKINS-RICHARDSON & ASSOCIATES
Entity Type:Organization
Organization Name:JENKINS-RICHARDSON & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS-RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S
Authorized Official - Phone:205-799-1274
Mailing Address - Street 1:1105 SOUTHVIEW LN STE 103
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6391
Mailing Address - Country:US
Mailing Address - Phone:205-799-1274
Mailing Address - Fax:
Practice Address - Street 1:1105 SOUTHVIEW LN STE 103
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6391
Practice Address - Country:US
Practice Address - Phone:205-799-1274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty