Individual
KYLLIE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC, CCGC
Contact information
Practice address
2751 WOODDALE BLVD STE A, BATON ROUGE, LA 70805-7567
(225) 362-5360
(855) 473-0115
Mailing address
PO BOX 66558, BATON ROUGE, LA 70896-6558
(225) 362-5360
(855) 473-0115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10600
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1080
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1389
LA
Other
Enumeration date
04/17/2017
Last updated
04/06/2026
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