Active NPI
Charles Lee Jenkins Jr., LCPC
- Professional Counselor
- Frederick, MD
National Provider Identifier
1164032942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC10688
- Practice address
- 4705 Verdana Loop
Frederick, MD 21703-2733 - Phone
- (301) 305-8511
- NPI assigned
- Aug 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC10688 | MD | Primary |
Addresses
Primary practice location
4705 Verdana Loop
Frederick, MD 21703-2733
Mailing address
4705 Verdana Loop
Frederick, MD 21703-2733
Phone (301) 305-8511
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10688 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
Interoperability endpoints
- charlesjenkins@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596585600000",
"number": "1164032942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4705 VERDANA LOOP",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217032733",
"telephone_number": "301-305-8511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 VERDANA LOOP",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217032733",
"telephone_number": "301-305-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "CHARLES",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-05",
"last_updated": "2020-08-05",
"certification_date": "2020-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC10688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.