Healthcare Provider Details

I. General information

NPI: 1750689295
Provider Name (Legal Business Name): SHEILA DELORIS JENKINS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 BARNWELL ST
COLUMBIA SC
29201-3566
US

IV. Provider business mailing address

92 JOHNNY LORICK RD
IRMO SC
29063-9461
US

V. Phone/Fax

Practice location:
  • Phone: 803-920-0473
  • Fax:
Mailing address:
  • Phone: 803-920-0473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: