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General NPI Number Information
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NPI Number | 1821962663
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Entity Type | Individual
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Provider Name | MARISSA M JENSEN LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2835 W SAINT GERMAIN ST STE 550
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City | SAINT CLOUD
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State | MN
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Zip | 56301-6389
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Country | US
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Telephone | 888-881-8261
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Fax | 320-031-6208
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Provider Business Mailing Address
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Address Line | 2835 W SAINT GERMAIN ST STE 550
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City | SAINT CLOUD
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State | MN
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Zip | 56301-6389
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Country | US
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Telephone | 888-881-8261
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Fax | 320-031-6208
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC05207
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License Number State | MN
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