Provider Demographics
NPI:1942441902
Name:JENKINS, DAWN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22136 WESTHEIMER PKWY
Mailing Address - Street 2:SUITE 456
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8296
Mailing Address - Country:US
Mailing Address - Phone:281-762-0542
Mailing Address - Fax:
Practice Address - Street 1:22136 WESTHEIMER PKWY
Practice Address - Street 2:SUITE 456
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8296
Practice Address - Country:US
Practice Address - Phone:281-762-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY042361OtherNEW YORK STATE EDUCATION DEPARTMENT