Tamara Jenkins, MSSW

Individual provider Active NPI Clinical Social Worker · Montgomery, AL

NPI 1720083371 · NPPES record last updated Aug 30, 2012

Key facts

NPI
1720083371
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0727C-130P (AL)
Practice address
4750-C Woodmere Blvd
Montgomery, AL 36106
Phone
(334) 244-7322
Fax
(334) 356-1603
NPI assigned
Jun 19, 2005
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0727C-130PALMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0727C-130P AL Yes

Addresses

Primary practice location

4750-C Woodmere Blvd
Montgomery, AL 36106

Mailing address

4750-C Woodmere Blvd
Montgomery, AL 36106
Phone (334) 244-7322

Other identifiers

IdentifierTypeStateIssuer
339051068MedicaidAL

Other providers in Montgomery, AL

All providers in Montgomery, AL · Clinical Social Worker in Alabama

Sources for this page

Verify at the official NPI Registry.