Healthcare Provider Details

I. General information

NPI: 1124943725
Provider Name (Legal Business Name): SHERYL DENINE JENKINS-LONG LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4084 WINDSOR HEIGHTS PL
WHITE PLAINS MD
20695-3463
US

IV. Provider business mailing address

4084 WINDSOR HEIGHTS PL
WHITE PLAINS MD
20695-3463
US

V. Phone/Fax

Practice location:
  • Phone: 301-802-4761
  • Fax:
Mailing address:
  • Phone: 301-802-4761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number$$$$$$$$$
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: