Healthcare Provider Details

I. General information

NPI: 1154262822
Provider Name (Legal Business Name): JENNIFER MARIE HENSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 PRIVATE ROAD 1934
WEST PLAINS MO
65775-5516
US

IV. Provider business mailing address

5519 PRIVATE ROAD 1934
WEST PLAINS MO
65775-5516
US

V. Phone/Fax

Practice location:
  • Phone: 417-204-3634
  • Fax:
Mailing address:
  • Phone: 417-204-3634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: