Healthcare Provider Details

I. General information

NPI: 1619779626
Provider Name (Legal Business Name): ALLISON JENSEN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 SHEPPARD DR
SAINT PETER MN
56082-2539
US

IV. Provider business mailing address

1715 SHEPPARD DR
SAINT PETER MN
56082-2539
US

V. Phone/Fax

Practice location:
  • Phone: 507-484-2400
  • Fax: 507-954-2594
Mailing address:
  • Phone: 507-484-2404
  • Fax: 507-934-2594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC03193
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: