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General NPI Number Information
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NPI Number | 1093255978
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Entity Type | Individual
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Provider Name | STEVE JENKINS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 308 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-2246
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Country | US
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Telephone | 718-351-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 3946 51ST ST APT. 1
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City | WOODSIDE
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State | NY
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Zip | 11377-3149
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Country | US
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Telephone | 347-671-5767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 022038
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License Number State | NY
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