Provider Demographics
NPI:1902098627
Name:WINKLER, JENNIFER L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:WINKLER
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 1:4329 COLLETTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLLETTSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28611-9000
Mailing Address - Country:US
Mailing Address - Phone:828-754-2409
Mailing Address - Fax:828-754-2418
Practice Address - Street 1:4329 COLLETTSVILLE RD
Practice Address - Street 2:
Practice Address - City:COLLETTSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28611-9000
Practice Address - Country:US
Practice Address - Phone:828-754-2409
Practice Address - Fax:828-754-2418
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0056131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106750Medicaid