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General NPI Number Information
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NPI Number | 1922280106
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Entity Type | Individual
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Provider Name | KAREN E JENSEN LCSW, CCM
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Gender | Female
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 500 HIGHWAY 89 NORTH
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City | PRESCOTT
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State | AZ
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Zip | 86313
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Country | US
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Telephone | 928-445-4860
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Fax | 928-776-6049
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Provider Business Mailing Address
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Address Line | 8450 N GRASS VALLEY LN
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86315-9310
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Country | US
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Telephone | 720-335-2829
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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 | LCSW-20160
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10950300-3501
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 950
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License Number State | CO
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