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General NPI Number Information
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NPI Number | 1912881517
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Entity Type | Individual
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Provider Name | MARTINA JENSEN LICSW
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Gender |
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1550 AMERICAN BLVD E STE 550
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City | BLOOMINGTON
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State | MN
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Zip | 55425-3100
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Country | US
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Telephone | 612-268-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 METRO BLVD STE 250
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City | EDINA
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State | MN
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Zip | 55439-3062
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Country | US
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Telephone |
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 31177
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License Number State | MN
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