Brandi C Jenkins, CDCA

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ironton, OH

NPI 1740907815 · NPPES record last updated Dec 15, 2022

Key facts

NPI
1740907815
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CDCA.182973 (OH)
Practice address
214 S 4TH St
Ironton, OH 45638-1610
Phone
(740) 532-3767
Fax
(740) 532-3385
NPI assigned
Oct 20, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CDCA.182973OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Outreach Services, LTD Addiction (Substance Use Disorder) Current
since Oct 23, 2022
Accepting new patients
Spectrum Outreach Services, LTD Past
since Oct 23, 2022
Accepting new patients

Locations

214 S 4th St
Ironton, OH 45638
Phone (740) 532-3767

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.182973 OH Yes

Addresses

Primary practice location

214 S 4TH St
Ironton, OH 45638-1610

Mailing address

214 S 4TH St
Ironton, OH 45638-1610
Phone (740) 532-3767

Other providers in Ironton, OH

All providers in Ironton, OH · Addiction (Substance Use Disorder) Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.