Active NPI
Wanda Ethel Jensen, LCSW
- Clinical Social Worker
- Lima, MT
National Provider Identifier
1154099588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 62696
- Practice address
- 120 W 3Rd Ave
Lima, MT 59739 - Phone
- (406) 660-0904
- NPI assigned
- Aug 31, 2021
- Last updated
- Mar 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 62696 | MT | Primary |
| Clinical Social Worker | 1041C0700X | 37100 | MT |
Addresses
Primary practice location
120 W 3Rd Ave
Lima, MT 59739
Mailing address
PO Box 13
Lima, MT 59739-0013
Phone (406) 660-0904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231205001376 | MT | Practitioner - Clinical Social Worker | 3678921459 | Practice locations: Lima, MT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37100 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1154099588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13",
"city": "LIMA",
"state": "MT",
"postal_code": "597390013",
"telephone_number": "406-660-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W 3RD AVE",
"city": "LIMA",
"state": "MT",
"postal_code": "59739",
"telephone_number": "406-660-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "WANDA",
"middle_name": "ETHEL",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2025-03-19",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "62696",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "37100",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lima, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.