Nicole Ann Jensen, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18-05-18 Issued in OR

Practice address

6025 SE Belmont St
Portland, OR 97215-1927

Phone

(503) 477-8495

Fax

(503) 208-2233

NPI assigned

Jun 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1124698899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151927",
            "telephone_number": "503-477-8495",
            "fax_number": "503-208-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151927",
            "telephone_number": "503-477-8495",
            "fax_number": "503-208-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "18-05-18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassandra Renee Jensen, DO
• Kyle Kristopher Jensen, M.D.
• Lisa Jensen, DMD
• Megan Alicia Jensen, BS
• Michael Jensen
• Rebecca Jensen, RBT
• Richard Clayne Jensen, M.D.
• Erin Jenson, PHARM.D.
• Laura Rene Jenson, MS, MPH, CNM, CPH
• William J Jenson, CRM

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.