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General NPI Number Information
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NPI Number | 1174482772
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Entity Type | Individual
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Provider Name | CHASITY JENKINS
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Gender | Female
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 170 OLD COUNTRY RD
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City | RIVERHEAD
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State | NY
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Zip | 11901-2198
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Country | US
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Telephone | 631-208-4460
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Fax |
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Provider Business Mailing Address
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Address Line | 23 B ST
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City | LAUREL
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State | MD
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Zip | 20707-4191
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Country | US
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Telephone | 917-568-5348
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 130480
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License Number State | NY
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