Charles Jenkins, PSY.D,

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3552 Issued in GA

Practice address

6065 Roswell Rd NE
Suite 725
Sandy Springs, GA 30328-4011

Phone

(770) 956-9213

Fax

(770) 956-9218

NPI assigned

Feb 9, 2007

Last updated

Apr 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Kennridge Psychological Associates

  • Clinical Psychologist
  • Sandy Springs, GA
  • NPI 1780716258
  NPD (past) Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1912048356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 JEFFREY PL",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300823678",
            "telephone_number": "770-956-9213",
            "fax_number": "770-956-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 ROSWELL RD NE",
            "address_2": "SUITE 725",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303284011",
            "telephone_number": "770-956-9213",
            "fax_number": "770-956-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PSY.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "3552",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amara James
• Arden James
• Nicole N James, NP
• Somally James
• Janaso Enterprises, LLC
• Johanna Brooks Jenkins, DDS
• Justin Jenkins
• Wendy Elizabeth Jenkins
• Kendall Jeter
• Jett Ferry Dental Group, PC (Jett Ferry Dental Group)

• Clinical Psychologist in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.