MEDICARE: DR. DAVID E. JENKINS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	103TB0200X	Cognitive & Behavioral Psychologist
3	103TC0700X	Clinical Psychologist	2037	NC
4	103TF0000X	Family Psychologist
5	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1134346158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E. JENKINS PSY.D.

Provider Business Mailing Address
First Line	:	105 MCINTOSH DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24503-3604
Country	:	US
Telephone Number	:	434-384-1872
Fax Number	:

Provider Business Practice Location Address
First Line	:	1971 UNIVERSITY BLVD
Second Line	:	CENTER FOR COUNSELING AND FAMILY STUDIES
City	:	LYNCHBURG
State	:	VA
Zip	:	24502-2269
Country	:	US
Telephone Number	:	434-592-4045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	09/11/2025

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