MEDICARE: MS. KAMA BREE JENSEN M.ED, LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Z00000X	Other Specialist/Technologist
2	101YP2500X	Professional Counselor	51261504193	ND

General Provider Information

NPI Number	:	1982927851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAMA BREE JENSEN M.ED, LPCC

Provider Business Mailing Address
First Line	:	3239 OAK RIDGE LOOP E
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-8482
Country	:	US
Telephone Number	:	701-478-7199
Fax Number	:	701-478-1763

Provider Business Practice Location Address
First Line	:	3239 OAK RIDGE LOOP E
Second Line	:
City	:	WEST FARGO
State	:	ND
Zip	:	58078-8482
Country	:	US
Telephone Number	:	701-478-7199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	12/16/2020

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