Healthcare Provider Details

I. General information

NPI: 1255719720
Provider Name (Legal Business Name): ASHLEY HENDRIX JENKINS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 TURTLE CREEK LN
HARLEM GA
30814-0045
US

IV. Provider business mailing address

614 TURTLE CREEK LN
HARLEM GA
30814-0045
US

V. Phone/Fax

Practice location:
  • Phone: 334-329-4315
  • Fax:
Mailing address:
  • Phone: 334-329-4315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW006434
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMSW006605
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: