Provider Demographics
NPI:1457549958
Name:JENKINS, NANCY J (LPC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMCHC
Mailing Address - Street 1:393 E RIVERSIDE DR STE 3A
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7127
Mailing Address - Country:US
Mailing Address - Phone:435-688-2123
Mailing Address - Fax:435-688-2353
Practice Address - Street 1:3833 SOUTH MITCHELL DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780
Practice Address - Country:US
Practice Address - Phone:801-949-1323
Practice Address - Fax:435-688-2353
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT358844-6004101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health