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NPI Code Detail

MEDICARE: MS. RITA VIRGINIA JENKINS LPC

MEDICARE: MS. RITA VIRGINIA JENKINS LPC
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
1101Y00000XCounselor4899TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
183954LOTHERTXBCBS OF TEXAS

General Provider Information

NPI Number : 1578561148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RITA VIRGINIA JENKINS LPC
Provider Business Mailing Address
First Line : PO BOX 416
Second Line :
City : TEMPLE
State : TX
Zip : 76503-0416
Country : US
Telephone Number : 254-774-8806
Fax Number : 254-774-9672
Provider Business Practice Location Address
First Line : 200 W CALHOUN AVE
Second Line :
City : TEMPLE
State : TX
Zip : 76501-3127
Country : US
Telephone Number : 254-774-8806
Fax Number : 254-774-9672
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 07/08/2007

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