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NPI Code Detail

MEDICARE: CHRISTOPHER JENSEN

MEDICARE: CHRISTOPHER JENSEN
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
1101YP2500XProfessional CounselorLPC.0012587CO
2101YP2500XProfessional CounselorLCPC-8745ID

General Provider Information

NPI Number : 1679005953
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JENSEN
Provider Business Mailing Address
First Line : 545 N BENJAMIN LN STE 185
Second Line :
City : BOISE
State : ID
Zip : 83704-9625
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 545 N BENJAMIN LN STE 185
Second Line :
City : BOISE
State : ID
Zip : 83704-9625
Country : US
Telephone Number : 785-350-4923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2017
Last Update Date : 01/12/2023

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Directions to “ CHRISTOPHER JENSEN ” Practice Location

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