Provider Demographics
NPI:1316770217
Name:JENKINS, DANELLE M (MA, LPCC)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:M
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 MACINTOSH CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-1764
Mailing Address - Country:US
Mailing Address - Phone:715-965-3977
Mailing Address - Fax:
Practice Address - Street 1:1856 MACINTOSH CT
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-1764
Practice Address - Country:US
Practice Address - Phone:715-965-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional