Dorothy Beatrice Jenkins, DOCTOR

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2480017 Issued in MI

Practice address

505 Beechwood St
River Rouge, MI 48218-1041

Phone

(313) 386-2288

Fax

(313) 386-5986

NPI assigned

Mar 19, 2010

Last updated

Mar 19, 2010By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Exec-U-Tech Behavioral Therapy

  • Community/Behavioral Health Agency
  • River Rouge, MI
  • NPI 1568776086
  NPD (past)

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1598089526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 IROQUOIS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142751",
            "telephone_number": "313-598-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BEECHWOOD ST",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181041",
            "telephone_number": "313-386-2288",
            "fax_number": "313-386-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "DOROTHY",
        "middle_name": "BEATRICE",
        "name_prefix": "Mrs.",
        "credential": "DOCTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "2480017",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "1984150",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "1984159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Harrison
• Nesiah Henderson
• Antoinette Hill
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• Theresa Jackson
• Helene Johnson-Powell
• Batrice Jones II
• Stacey Junior
• Diane Matthewsmatthews01
• Kassie L McKnight

• Psychologist in River Rouge, MI
• Providers in River Rouge, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.