Matthew Jenkins, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.175539 Issued in OH

Practice address

32 Portsmouth St
Jackson, OH 45640-1622

Phone

(740) 286-2918

Fax

(740) 286-1374

NPI assigned

Oct 7, 2021

Last updated

Oct 7, 2021By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1366104390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WARD RD",
            "city": "BIDWELL",
            "state": "OH",
            "postal_code": "456149342",
            "telephone_number": "740-645-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PORTSMOUTH ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401622",
            "telephone_number": "740-286-2918",
            "fax_number": "740-286-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MATTHEW",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.175539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Jarvis
• Erick Jayjohn, DDS
• Jordan Jayjohn, QMHS
• Cameron Wade Jenkins
• Christina Beth Jenkins
• Angela Sue Johnson, R.PH.
• April S. Johnson, CNP
• Joel Johnson
• Sabrina Johnson
• Nichole Ann Johnston

• Addiction (Substance Use Disorder) Counselor in Jackson, OH
• Providers in Jackson, 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 Oct 7, 2021; 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.