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Individual
MR. BROCK DEVERE CARTER JENIKOVSKY
Active
Individual
MR. BROCK DEVERE CARTER JENIKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC III, ICADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A051980920
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/30/2024
Last updated
08/19/2026
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