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Individual

DR. LINDA A. JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-R, PSYD, PHD

Contact information

Practice address
10323 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11429-2050
(718) 977-3762
(718) 525-6902
Mailing address
10323 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11429-2050
(718) 977-3762
(718) 525-6902

Taxonomy

Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
R-046371
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01719406
NY
01
135053
VALUEOPTIONS PROVIDER#
NY
01
7479339
GHI PROVIDER #
NY
01
7582088
AETNA PROVIDER #
NY
01
N5H31
BC-BS MEDICARE PROVIDER#
NY
01
NYS046371
CARE MANAGEMENT GROUP #
NY
01
P670175
OXFORD PROVIDER#
NY
01
R-046371
1199 PROVIDER#
NY
Enumeration date
04/16/2007
Last updated
07/09/2007
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