Healthcare Provider Details

I. General information

NPI: 1588528376
Provider Name (Legal Business Name): TRINITY JENKINS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E 400 N
ROOSEVELT UT
84066-3501
US

IV. Provider business mailing address

HC 65 BOX 34
MOUNTAIN HOME UT
84051
US

V. Phone/Fax

Practice location:
  • Phone: 435-725-4683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: