Healthcare Provider Details

I. General information

NPI: 1245991132
Provider Name (Legal Business Name): MADELINE JENKINS MED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADELINE QUINN

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 HILL RD N
PICKERINGTON OH
43147-1159
US

IV. Provider business mailing address

545 HILL RD N
PICKERINGTON OH
43147-1159
US

V. Phone/Fax

Practice location:
  • Phone: 888-891-8567
  • Fax:
Mailing address:
  • Phone: 888-891-8567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2606938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: