Individual provider · Type 1 NPI

Brock Devere Carter Jenikovsky, CADC III, ICADC

Addiction (Substance Use Disorder) Counselor · Indio, CA

NPI number 1730936642 Active

Practice location

44359 Palm St
Indio, CA 92201-3116

Call (760) 342-6616 Map

Fax (760) 347-8276

Other practice locations

  • 333 S Farrell Dr, Palm Springs, CA 92262-7905 · (760) 416-1360

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XA051980920 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1730936642

Brock Devere Carter Jenikovsky, CADC III, ICADC's National Provider Identifier is 1730936642, issued on Apr 30, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Indio, CA. The record was last updated on Aug 19, 2026.