Stephen Sean Jenkins, PHD, ABPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4757 Issued in MN

Practice address

1400 W Saint Germain St Ste 105
Saint Cloud, MN 56301-4101

Phone

(320) 253-3715

NPI assigned

Aug 12, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stephen Jenkins PHD Abpp LP PLLC

  • Clinical Psychologist
  • Saint Cloud, MN
  • NPI 1942870001

  Clinical

  NPD Authorized official
• Psychotherapeutic Resources LLP

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1619059755
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1013528207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W SAINT GERMAIN ST STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014180",
            "telephone_number": "320-253-3715",
            "fax_number": "320-252-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W SAINT GERMAIN ST STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014101",
            "telephone_number": "320-253-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "STEPHEN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "PHD, ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JD Home Health Care
• Jennifer Jedlicka, MSW, LICSW
• Jeffrey M Mies DC Inc
• Jelle Consultant LLC
• Isnino Jelle
• Christina Ann Jenner, M.D.
• Kevin S Jenner, M.D.
• Kelli Jo Jensch, RD, LD
• Jaime Lynne Jensen
• Joyce C Jensen, CRNA

• All providers in Saint Cloud, MN
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.