Active NPI
Laci Jensen
- Mental Health Counselor
- Bellevue, WA
National Provider Identifier
1003309089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 61399348
- Practice address
- 11911 NE 1St St Ste 205
Bellevue, WA 98005-3056 - Phone
- (971) 801-2054
- NPI assigned
- Jun 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61399348 | WA | Primary |
Addresses
Primary practice location
11911 NE 1St St Ste 205
Bellevue, WA 98005-3056
Mailing address
7530B 15TH Ave NW
Seattle, WA 98117-5453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61399348 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agaetra Family Therapy | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1003309089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7530B 15TH AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981175453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11911 NE 1ST ST STE 205",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980053056",
"telephone_number": "971-801-2054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "LACI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-13",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "61399348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.