Mark E Jenkins Jr., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LICSW1130671 Issued in MA

Practice address

605 State St
Springfield, MA 01109-4114

Phone

(413) 266-2207

NPI assigned

Aug 11, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Neighborhood Guidance, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
  • NPI 1386456853
  NPD Authorized official
• African Diaspora Mental Health Association LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
  • NPI 1558884338
  NPD

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

{
    "created_epoch": "1565481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1184270779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011094114",
            "telephone_number": "413-266-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011094114",
            "telephone_number": "413-266-2207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 E Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011052506",
            "country_code": "US",
            "telephone_number": "413-733-3488 x129",
            "fax_number": "413-731-7381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1130671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://00151201",
            "affiliation": "Y",
            "affiliationName": "Habit Optco Acadia Healthcare",
            "address_1": "11 Circle Ave",
            "city": "Lynn",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019053050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Marie Jediny
• Raeven Jemison
• Lisa R Jenike, NP
• Amanda M Jeniski
• Angela Jenkins, N/A
• Tashea Jenkins
• Trevor C Jenkins
• Jocelyn R Jensen, MD
• Alexander Miles Jenson
• Hal Brockbank Jenson, MD, MBA

• Clinical Social Worker in Springfield, MA
• Providers in Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.