Kellie J Jensen

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

661 Issued in WY

Legal business name

KELLIE J JENSEN

Practice address

729 Fort St
Buffalo, WY 82834-2316

Phone

(307) 217-1311

Fax

(307) 684-2182

NPI assigned

Oct 30, 2012

Last updated

Oct 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kellie J Jensen, LCSWNPI 1982837712

Title

Licensed Clinical Social Worker

Phone

(307) 217-1311

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kellie Jo Jensen, LCSW

  • Clinical Social Worker
  • Buffalo, WY
  • NPI 1982837712
  NPD Authorized official

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1023362035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 FORT ST",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342316",
            "telephone_number": "307-217-1311",
            "fax_number": "307-684-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 FORT ST",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342316",
            "telephone_number": "307-217-1311",
            "fax_number": "307-684-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLIE J JENSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "307-217-1311",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnson County Memorial Hospital (Susie Bowling Lawrence Hospice)
• Johnson County Memorial Hospital (Johnson County Healthcare Center Home Health Agency)
• Johnson County Rural Health Care District
• James Loren Johnson Jr., DC
• Christopher Leroy Jons, O.D.
• Samantha Marie Kessler, LPC
• Elizabeth Ketterling
• Joel Killian
• Lawrence Edward Kirven, MD
• Melissa Knapp, DC

• Clinical Social Worker in Buffalo, WY
• Providers in Buffalo, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.