MRS. DETRIA S JENKINS (NPI# 1063697019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063697019 |
| Entity Type | Individual |
| Full Name | MRS. DETRIA S JENKINS |
| Practice Address |
130 Desiard St Suite 412 Monroe LA 71201-7319 |
| Mailing Address |
Po Box 1222 West Monroe LA 71294-1222 |
| Practice Telephone | 3183873545 |
| Practice Fax Number | 3183873541 |
| Mailing Telephone | 3183873545 |
| Mailing Fax Number | 3183873541 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2018-12-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
PCA 14071 | LA | Nursing Service Related Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
130 DESIARD ST SUITE 412 |
| City | MONROE |
| State | LA |
| Zip Code | 71201-7319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992103782 | Affinity Health Group, LLC | Clinic/Center | 130 Desiard St, Suite 355, Monroe, LA 71201-7319 | 2014-12-11 |
| 1922382100 | J Monica Guerriero | Pharmacist | 130 Desiard St, Suite 300, Monroe, LA 71201-7319 | 2011-10-05 |
| 1467736843 | Kris Mckown | Pharmacist | 130 Desiard St, Suite 300, Monroe, LA 71201-7319 | 2011-10-04 |
| 1841588704 | Lori Leggitt Gaubert | Pharmacist | 130 Desiard St, Suite 300, Monroe, LA 71201-7319 | 2011-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
| 1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
| 1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
| 1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
| 1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
| 1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
| 1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
| Find all providers in zip 71201 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538781638 | John R Webb | Counselor | 2013 Spencer Ave, Monroe, LA 71201-2719 | 2020-05-12 |
| 1205474178 | Lotus Counseling & Consulting LLC | Counselor | 2439 5th St, Monroe, WI 53566-1504 | 2019-12-11 |
| 1851949879 | Mark Edward Hersh | Counselor | 220 Fernhead Ave, Monroe, NJ 08831-8736 | 2019-09-03 |
| 1184103749 | Lauren Allender | Counselor | 4 Whitetail Dr, Monroe, CT 06468-1485 | 2018-08-14 |
| 1518452820 | Kakietha Keys | Counselor | 154 Preston Loop, Monroe, LA 71202-6912 | 2018-06-28 |
| 1356830541 | David Whitney Bass | Counselor | 622 Riverside Drive, Monroe, La. 71203, Monroe, LA 71203 | 2018-05-03 |
| 1366956435 | Paulette Roberts | Counselor | 1800 Stubbs Ave, Monroe, LA 71201 | 2017-11-27 |
| 1073025318 | Gp Consulting, LLC | Counselor | 300 Washington St Ste 100d, Monroe, LA 71201-6751 | 2017-10-26 |
| 1588180103 | Barbara Verran | Counselor | 824 S Monroe St, Monroe, MI 48161-1432 | 2017-08-15 |
| 1588184816 | Janice Price | Counselor | 2017 Hudson Lane, Monroe, LA 71201 | 2017-06-27 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.