Healthcare Provider Details

I. General information

NPI: 1114220803
Provider Name (Legal Business Name): KERI L JENKINS MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 W COVELL RD STE 100
EDMOND OK
73003-2381
US

IV. Provider business mailing address

755 W COVELL RD STE 100
EDMOND OK
73003-2381
US

V. Phone/Fax

Practice location:
  • Phone: 405-378-2727
  • Fax:
Mailing address:
  • Phone: 405-378-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number081240263
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC06697
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC06697
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: