Organization
H. DIANE JENKINS, LLC
Active
Other names
GAC Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
HARRIET DIANE JENKINS LCSW (CEO)
(336) 575-3747
Entity
Organization
Contact information
Practice address
110 W ELM ST, YADKINVILLE, NC 27055-3313
(336) 575-3747
(866) 413-4793
Mailing address
2820 NORTHBRIDGE RD, WINSTON SALEM, NC 27103-6517
(336) 575-3747
(866) 413-4793
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C002645
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003126
—
NC
Enumeration date
09/04/2007
Last updated
10/05/2007
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