Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Brock Devere Carter Jenikovsky, CADC-II, ICADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1730936642

Mr. Brock Devere Carter Jenikovsky, CADC-II, ICADC is an Addiction (Substance Use Disorder) Counselor in Indio, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

44359 Palm St
Indio, CA 92201-3116
Phone: (760) 342-6616
Fax: (760) 347-8276
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence A051980920 (CA)

Record details

NPI number1730936642
Entity typeIndividual (Type 1)
GenderMale
Credentials CADC-II , ICADC
Sole proprietorNo
NPI enumeratedApril 30, 2024
Last updated in NPPESApril 30, 2024
Certification dateApril 30, 2024

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