Provider Demographics
NPI:1366874075
Name:JENKINS, VALERIE LOWE (CSW03593)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LOWE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CSW03593
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 VINELAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-5739
Mailing Address - Country:US
Mailing Address - Phone:601-842-3847
Mailing Address - Fax:
Practice Address - Street 1:2147 HENRY HILL DR STE 109
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-2046
Practice Address - Country:US
Practice Address - Phone:601-714-2821
Practice Address - Fax:855-341-7510
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP1600X
RICSW035931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral