Eddie Jenkins, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1594 Issued in LA

Practice address

856 Texas Ave
Shreveport, LA 71101-3400

Phone

(318) 426-8096

Fax

(318) 227-6179

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Volunteers of America of North Louisiana

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
  • NPI 1417252230
  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1871912873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042312",
            "telephone_number": "318-429-7500",
            "fax_number": "318-227-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 TEXAS AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013400",
            "telephone_number": "318-426-8096",
            "fax_number": "318-227-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "EDDIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "1594",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "1594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417252230",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany M Jellum, PTA
• Jenkins Counseling Services, LLC
• Anthony Leonard Jenkins, PHARM.D.
• Cora Jean Jenkins
• Demirion Jenkins
• Emily J Jenkins
• Kandi Jenkins
• Lynn Gibbs Jenkins, LOTR
• Miranda Jenkins
• Rashima R Jenkins

• Clinical Social Worker in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.