Provider Demographics
NPI:1063212124
Name:ADKINS, JENNA BROOKE (LPC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:BROOKE
Last Name:ADKINS
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-0146
Mailing Address - Country:US
Mailing Address - Phone:304-768-5506
Mailing Address - Fax:304-768-5508
Practice Address - Street 1:101 CARRIAGE WAY
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-1530
Practice Address - Country:US
Practice Address - Phone:304-768-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health