MEDICARE: MRS. CHERYL A JENSEN L.C.S.W

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05293100	NJ

General Provider Information

NPI Number	:	1093986077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL A JENSEN L.C.S.W

Provider Business Mailing Address
First Line	:	3322 ROUTE 22 WEST BRANCHBURG COMMONS
Second Line	:	BUILDING 4, SUITE 412
City	:	BRANCHBURG
State	:	NJ
Zip	:	08876
Country	:	US
Telephone Number	:	908-872-6475
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 N BRANCH RIVER RD
Second Line	:
City	:	BRANCHBURG
State	:	NJ
Zip	:	08876-3709
Country	:	US
Telephone Number	:	908-872-6475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	03/18/2008

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