Provider Demographics
NPI:1881070464
Name:JENKINS, AIMEE (LCSW)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1448
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-1448
Mailing Address - Country:US
Mailing Address - Phone:336-694-9331
Mailing Address - Fax:336-694-7511
Practice Address - Street 1:439 US HIGHWAY 158 W
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379-8304
Practice Address - Country:US
Practice Address - Phone:336-694-9331
Practice Address - Fax:336-694-7511
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP009941101YM0800X, 104100000X, 106H00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist