Provider Demographics
NPI:1114774346
Name:JENKINS, KATHLEEN (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 S PEEK RD APT 3117
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3713
Mailing Address - Country:US
Mailing Address - Phone:832-475-1201
Mailing Address - Fax:
Practice Address - Street 1:1638 W ALABAMA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-4102
Practice Address - Country:US
Practice Address - Phone:713-628-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX88847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional