Individual
CANDICE S JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
300 MEDICAL DR, HAMPTON, VA 23666-1765
(757) 788-0092
(757) 788-0969
Mailing address
300 MEDICAL DR, HAMPTON, VA 23666-1765
(757) 788-0092
(757) 788-0969
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701001585
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288758
ANTHEM
VA
01
—
530482000
MAGELLAN
VA
05
—
5414628
—
VA
Enumeration date
08/21/2006
Last updated
12/20/2007
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