Sandra Jensen, PHD
Individual provider Active NPI Clinical Psychologist · Rapid City, SD
NPI 1003975467 · NPPES record last updated Jul 4, 2019
Key facts
- NPI
- 1003975467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 559 (SD)
- Practice address
- 4851 Cliff Dr
Rapid City, SD 57702 - Phone
- (850) 339-7660
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6897 | FL | MD | Clinical Psychologist |
| WY530 | WY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meditelecare of New Mexico, LLC | Clinical | Current |
Accepting new patients |
| South Sound Radiologists Inc P S | Past | Accepting new patients | |
| Senior Psych Solutions Corp | Clinical | Past | Accepting new patients |
Locations
206 S Coronado Ave
Espanola, NM 87532
Phone (833) 807-8727
Interoperability endpoints
- sandra.jensen.1@30520.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | WY530 | WY | |
| Clinical Psychologist | 103TC0700X | PY6897 | FL | |
| Clinical Psychologist | 103TC0700X | 559 | SD | Yes |
Addresses
Primary practice location
4851 Cliff Dr
Rapid City, SD 57702
Mailing address
4851 Cliff Dr
Rapid City, SD 57702-6817
Phone (850) 339-7660
Other practice location 1
1218 Cosgriff Ct
Suite 201
Cheyenne, WY 82001-2410
Phone (850) 339-7660
Other practice location 2
1218 Cosgriff Ct
Suite 201
Cheyenne, WY 82001-2410
Phone (850) 339-7660
Other providers in Rapid City, SD
- Debby Jensen
- Jacqueline Jensen
- Jarrett Jensen
- Julie Ann Jensen
- Kiana Rae Jensen
- Trysta Ann Jensen
- Amy Jean Jenson
- Jacque Jepsen-Bakke
- Adam Jerke
- Kelly D Jerred
All providers in Rapid City, SD · Clinical Psychologist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.