Individual
ASHA D JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10046 S WESTERN AVE, CHICAGO, IL 60643-1926
(708) 825-5909
Mailing address
20129 LAKE PARK DR., LYNWOOD, IL 60411
(708) 825-5909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.013313
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
06/09/2021
Last updated
06/09/2021
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