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General NPI Number Information
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NPI Number | 1790375590
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Entity Type | Organization
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Legal Business Name | DAWN JENKINS LMSW
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 967 SPAULDING AVE SE STE E
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City | ADA
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State | MI
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Zip | 49301-3703
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Country | US
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Telephone | 616-259-5157
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 PONTIAC RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-3339
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Country | US
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Telephone | 616-901-5356
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Fax |
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Authorized Official
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Title or Position | LICENSED SOCIAL WORKER
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Name | DAWN J JENKINS
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Credential | LMSW
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Telephone | 616-901-5356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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