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NPI Code Detail

MEDICARE: DAVID JENSEN LCSW

MEDICARE: DAVID JENSEN LCSW
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
11041C0700XClinical Social Worker16918AZ

General Provider Information

NPI Number : 1225650211
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JENSEN LCSW
Provider Business Mailing Address
First Line : 843 MILLER VALLEY RD
Second Line :
City : PRESCOTT
State : AZ
Zip : 86301-1855
Country : US
Telephone Number : 928-224-2228
Fax Number :
Provider Business Practice Location Address
First Line : 1815 W SAINT MARYS RD
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2653
Country : US
Telephone Number : 480-390-5391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2020
Last Update Date : 09/05/2023

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Directions to “ DAVID JENSEN LCSW” Practice Location

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