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General NPI Number Information
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NPI Number | 1497260517
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Entity Type | Organization
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Legal Business Name | NAVONT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 1895 BRIGHTSEAT RD
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City | HYATTSVILLE
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State | MD
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Zip | 20785-4250
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Country | US
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Telephone | 215-360-7981
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Fax |
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Provider Business Mailing Address
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Address Line | 2065 TACKETTS VILLAGE SQ APT 301
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City | WOODBRIDGE
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State | VA
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Zip | 22192-3428
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Country | US
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Telephone | 215-360-7981
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEVIN N. JENKINS
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Credential | M. ED., LCPC
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Telephone | 215-360-7981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC7667
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License Number State | MD
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