Kishwa Marie Jenkins

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.191003 Issued in OH

Practice address

600 Freedom Dr
Napoleon, OH 43545-9021

Phone

(440) 260-6835

NPI assigned

May 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1083463186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FREEDOM DR",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459021",
            "telephone_number": "440-260-6835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1895 Oakwood Ave",
            "address_purpose": "LOCATION",
            "city": "Napoleon",
            "state": "OH",
            "postal_code": "435459243",
            "country_code": "US",
            "telephone_number": "440-260-6835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "KISHWA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.191003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Irene Husting, LSW
• Amanda Kaye Hutton, LPN
• Intentional Therapy Care LLC
• Michele Jakutowicz, PHARMD
• Jeffrey S. Lauf, O.D.
• Susan E Jilek, RPH, BCNSP
• Destinie Johnson, LPN
• Nola Aurora Johnson, LPN
• Bruce Jones, QMHS
• Dennis Arthur Jones, R.PH.

• Addiction (Substance Use Disorder) Counselor in Napoleon, OH
• Providers in Napoleon, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.