Individual provider Active NPI

Dominiqiue Janay Jenkins

  • Mental Health Counselor
  • Avondale, AZ
National Provider Identifier
1013614213
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10320 W McDowell Rd Ste 7022
Avondale, AZ 85392-4871
Phone
(623) 215-8189
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10320 W McDowell Rd Ste 7022
Avondale, AZ 85392-4871

Mailing address

335 N Alma School Rd
Chandler, AZ 85224-4363
Phone (480) 641-1165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Professional Counseling Services, Inc PastSince Feb 12, 2023 Accepting new patients
Lifeline at Alphaomega PastSince Feb 12, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1013614213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N ALMA SCHOOL RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244363",
            "telephone_number": "480-641-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 W MCDOWELL RD STE 7022",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924871",
            "telephone_number": "623-215-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DOMINIQIUE",
        "middle_name": "JANAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.