MS. JACQUELYN BETH JENSEN


Address: 41 W Encanto Blvd Apt 4, Phoenix, AZ 85003-1132
Phone: 6025731661

MS. JACQUELYN BETH JENSEN (NPI# 1205232352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205232352
Entity Type Individual
Full Name MS. JACQUELYN BETH JENSEN
Credential MSW, LISAC
Practice Address 41 W Encanto Blvd Apt 4
Phoenix
AZ 85003-1132
Practice Telephone 6025731661
Mailing Telephone 6025731661
Enumeration Date 2014-11-17
Last Update Date 2019-09-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2319 N. 51st Place #2, Phoenix, AZ 85008 4802214875

Office Location

Street Address 41 W ENCANTO BLVD APT 4
City PHOENIX
State AZ
Zip Code 85003-1132

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 85003

Improve Information

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Dataset Information

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.

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