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Individual

MISS THOMASINA MARIE JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW,CSAC

Contact information

Practice address
5650 N GREEN BAY AVE STE 205, GLENDALE, WI 53209-4446
(262) 999-3495
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(262) 999-3495

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15353-132
WI
1041C0700X
Clinical Social Worker
Primary
7605-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43715900
WI
Enumeration date
03/19/2007
Last updated
09/04/2025
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