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NPI Code Detail

MEDICARE: ANTHONY E JENKINS JR.

MEDICARE: ANTHONY E JENKINS JR.
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1659809598
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY E JENKINS JR.
Provider Business Mailing Address
First Line : 617 E MADISON AVE
Second Line :
City : BASTROP
State : LA
Zip : 71220-3833
Country : US
Telephone Number : 318-239-3890
Fax Number : 318-239-3891
Provider Business Practice Location Address
First Line : 617 E MADISON AVE
Second Line :
City : BASTROP
State : LA
Zip : 71220-3833
Country : US
Telephone Number : 318-239-3890
Fax Number : 318-239-3891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2017
Last Update Date : 07/21/2025

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