Individual provider Active NPI

James Arnold Jensen, PHD

  • Psychologist
  • Wauwatosa, WI
National Provider Identifier
1083777635
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1769 Issued in WI
Practice address
3800 N Mayfair Rd
Lutheran Counseling & Family Services
Wauwatosa, WI 53222
Phone
(414) 536-8333
Fax
(414) 536-8348
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1769 WI Primary

Addresses

Primary practice location

3800 N Mayfair Rd
Lutheran Counseling & Family Services
Wauwatosa, WI 53222

Mailing address

7300 W State St Apt 305
Wauwatosa, WI 53213-2765
Phone (414) 248-1615

Other identifiers 1

IdentifierTypeStateIssuer
39105400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140811000809 WI Practitioner - Clinical Psychologist 9032336334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shorehaven Behavioral Health IncGroup PAC ID 0143324954, 12 clinicians

Practice addresses (Care Compare)

3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209-1220
Phone 4145402170256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Shorehaven Behavioral Health Inc CurrentSince Jan 1, 2015 Accepting new patients
Compassionate Doctors Inc CurrentSince May 1, 2014 Accepting new patients
Zezenya Health Care S.C. Past Accepting new patients

Locations

4370 S 76th St
Greenfield, WI 53220

1672 S 9th St
Milwaukee, WI 53204
Phone (414) 389-1539

3900 W Brown Deer Rd
Ste 200
Milwaukee, WI 53209

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1083777635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 W STATE ST APT 305",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132765",
            "telephone_number": "414-248-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N MAYFAIR RD",
            "address_2": "LUTHERAN COUNSELING & FAMILY SERVICES",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53222",
            "telephone_number": "414-536-8333",
            "fax_number": "414-536-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JAMES",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39105400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.