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General NPI Number Information
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NPI Number | 1811182504
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Entity Type | Individual
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Provider Name | BARBARA JENKINS PH.D
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Gender | Female
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1227 AUGUSTA WEST PKWY
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City | AUGUSTA
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State | GA
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Zip | 30909-6670
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Country | US
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Telephone | 706-631-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 PEROT DR
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City | HEPHZIBAH
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State | GA
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Zip | 30815-6921
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Country | US
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Telephone | 706-399-5036
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC006291
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY10717
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License Number State | GA
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