Healthcare Provider Details

I. General information

NPI: 1407498082
Provider Name (Legal Business Name): RHONDA R JENKINS MBA. MHA, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 MONROE DR NE STE A102
ATLANTA GA
30308-2183
US

IV. Provider business mailing address

931 MONROE DR NE STE A102
ATLANTA GA
30308-2183
US

V. Phone/Fax

Practice location:
  • Phone: 404-457-0490
  • Fax:
Mailing address:
  • Phone: 404-457-0490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA0008620191
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: