Individual
GREGORY JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
101 NORTHFIELD DR APT J3, NORMAL, IL 61761-4769
(309) 660-7635
Mailing address
2014 W RIVIERA DR, PEORIA, IL 61614-3350
(309) 660-7635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.015961
IL
101YP2500X
Professional Counselor
Primary
180.014538
IL
Other
Enumeration date
11/03/2021
Last updated
02/06/2026
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