Provider Demographics
NPI:1851504021
Name:LENKER, JEFFREY L (LCSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:LENKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 SUZANNE WAY 120
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7619
Mailing Address - Country:US
Mailing Address - Phone:541-345-2800
Mailing Address - Fax:541-345-4419
Practice Address - Street 1:401 E 10TH AVE STE 330
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3357
Practice Address - Country:US
Practice Address - Phone:800-922-7009
Practice Address - Fax:877-730-5113
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL26171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR810573161OtherCLINIC TAX ID
OR844704001OtherREGENCE BCBSO PROV NO
OR810573161OtherCLINIC TAX ID