Healthcare Provider Details

I. General information

NPI: 1104744804
Provider Name (Legal Business Name): LAURA JENKINS DBA LBJENKINS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HILLENDALE AVE
NAZARETH PA
18064-9163
US

IV. Provider business mailing address

111 HILLENDALE AVE
NAZARETH PA
18064-9163
US

V. Phone/Fax

Practice location:
  • Phone: 848-202-5776
  • Fax:
Mailing address:
  • Phone: 848-202-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAURA JENKINS
Title or Position: OWNER/PRACTITIONER
Credential:
Phone: 848-202-5776