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General NPI Number Information
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NPI Number | 1083498166
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Entity Type | Organization
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Legal Business Name | JIL W. JENSEN
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 14890 LEGACY OAKS DR
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City | CARMEL
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State | IN
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Zip | 46032-0045
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Country | US
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Telephone | 240-475-0143
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Fax |
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Provider Business Mailing Address
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Address Line | 14890 LEGACY OAKS DR
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City | CARMEL
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State | IN
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Zip | 46032-0045
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Country | US
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Telephone | 240-475-0143
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | JIL WHITTLE JENSEN
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Credential | LCSW-C
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Telephone | 301-498-7569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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