Active NPI
Frederick Mauger Jenkins
- Counseling Psychologist
- Camp Hill, PA
National Provider Identifier
1790374502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PS007922L
- Practice address
- 337 Blacklatch LN
Camp Hill, PA 17011-8413 - Phone
- (717) 620-1291
- NPI assigned
- Jan 15, 2021
- Last updated
- Jan 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC000070 | PA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | PS007922 | ||
| Counseling Psychologist | 103TC1900X | PS007922L | Primary |
Addresses
Primary practice location
337 Blacklatch LN
Camp Hill, PA 17011-8413
Mailing address
337 Blacklatch LN
Camp Hill, PA 17011-8413
Phone (717) 620-1291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC000070 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1790374502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 BLACKLATCH LN",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170118413",
"telephone_number": "717-620-1291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 BLACKLATCH LN",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170118413",
"telephone_number": "717-620-1291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "FREDERICK",
"middle_name": "MAUGER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-15",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "PC000070",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": "PS007922",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": "PS007922L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.