Individual
TISHA R JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
404 E PAGE AVE, MALVERN, AR 72104-4248
(501) 786-9308
(818) 864-0043
Mailing address
PO BOX 224, MALVERN, AR 72104-0224
(501) 786-9308
(818) 864-0043
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2581-M
AR
1041C0700X
Clinical Social Worker
Primary
4482-C
AR
Other
Enumeration date
09/10/2009
Last updated
01/22/2026
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