Carla Jensen, PHD, LCSW MFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-24629 Issued in ID

Practice address

198 S Old Quarry Way
Boise, ID 83709-0541

Phone

(208) 914-0877

Fax

(208) 321-2773

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 17, 2024 through Sep 17, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Universal Enterprise Services

  • Clinic/Center
  • Boise, ID
  • NPI 1851072698
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1023176708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 S OLD QUARRY WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090541",
            "telephone_number": "208-914-0877",
            "fax_number": "208-429-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 S OLD QUARRY WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090541",
            "telephone_number": "208-914-0877",
            "fax_number": "208-321-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-2911",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-24629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "L3928",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010147740",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jensen Wellness
• Elsbeth Chiyo Jensen-Otsu, MD
• Adrianne Jensen, DPT
• Andrew Jensen, D.C.
• Brittany Jensen, NP-C
• Christopher Jensen
• Denise R Jensen, LMSW
• Ginger Ann Jensen, NNP
• James David Jensen, LPC
• Jenni Kay Jensen, ARNP-C

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.