MEDICARE: MRS. VALERIE LOWE JENKINS CSW03593

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW03593	RI
2	101Y00000X	Counselor
3	101YM0800X	Mental Health Counselor
4	101YP1600X	Pastoral Counselor
5	1041C0700X	Clinical Social Worker	149031492	IL

General Provider Information

NPI Number	:	1366874075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE LOWE JENKINS CSW03593

Provider Business Mailing Address
First Line	:	537 VINELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-5739
Country	:	US
Telephone Number	:	601-842-3847
Fax Number	:

Provider Business Practice Location Address
First Line	:	2147 HENRY HILL DR STE 109
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39204-2046
Country	:	US
Telephone Number	:	601-714-2821
Fax Number	:	855-341-7510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	03/11/2026

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