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General NPI Number Information
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NPI Number | 1962922872
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Entity Type | Individual
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Provider Name | STUART MURRAY JINKINS MSW MCAP
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Gender | Male
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12096 ALT A1A F4
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410
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Country | US
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Telephone | 561-601-0282
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Fax |
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Provider Business Mailing Address
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Address Line | 12096 ALT A1A APT F4
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2354
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Country | US
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Telephone | 561-601-0282
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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 | MCAP100310
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License Number State | FL
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