Whitney Nicole Jerkins, ALC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4310 Issued in AL

Practice address

701 Forrest Ave
East Brewton, AL 36426-2520

Phone

(251) 286-0707

NPI assigned

Dec 30, 2019

Last updated

Dec 11, 2023By the provider in NPPES

Sex

Female

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

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Enliven Therapy LLCGroup PAC ID 1951753698, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Enliven Therapy LLC

  • Counselor
  • East Brewton, AL
  • NPI 1013630284
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1588203251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 FORREST AVE",
            "city": "EAST BREWTON",
            "state": "AL",
            "postal_code": "364262520",
            "telephone_number": "251-286-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 FORREST AVE",
            "city": "EAST BREWTON",
            "state": "AL",
            "postal_code": "364262520",
            "telephone_number": "251-286-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERKINS",
        "first_name": "WHITNEY",
        "middle_name": "NICOLE",
        "credential": "ALC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "4310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Blunt, ALC
• Cottrell's Hometown Pharmacy PC (Cottrell's Hometown Pharmacy)
• Susan Denney, H.A.S.
• Enliven Therapy LLC
• Moore Therapy Services, P.C.
• Amy C Moore, MS, CCC-SLP
• Shannon Raines Thompson, RPH

• Mental Health Counselor in East Brewton, AL
• Providers in East Brewton, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.