Individual
MR. JEFFREY KEITH JENKINS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, LPC LMFT EMDR
Contact information
Practice address
316 W MAIN ST, HENRYETTA, OK 74437-4240
(405) 328-3620
Mailing address
PO BOX 53, HENRYETTA, OK 74437-0053
(405) 328-3620
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PENDING
OK
101Y00000X
Counselor
—
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
101YM0800X
Mental Health Counselor
PENDING
OK
106H00000X
Marriage & Family Therapist
PENDING
OK
Other
Enumeration date
08/22/2011
Last updated
06/09/2015
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