Healthcare Provider Details

I. General information

NPI: 1902737604
Provider Name (Legal Business Name): LORI JENKINS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 VENETIAN CT STE 1
NAPLES FL
34109-8727
US

IV. Provider business mailing address

2230 VENETIAN CT STE 1
NAPLES FL
34109-8727
US

V. Phone/Fax

Practice location:
  • Phone: 239-236-5448
  • Fax: 239-631-8470
Mailing address:
  • Phone: 239-236-5448
  • Fax: 239-631-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26582
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: