Camille Jensen, MA, LPCC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC03175 Issued in MN

Practice address

1250 Moore Lake Dr E Ste 205C
Fridley, MN 55432-5176

Phone

(763) 244-6516

NPI assigned

Feb 11, 2022

Last updated

Oct 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Wild & Free Counseling

  • Community/Behavioral Health Agency
  • Fridley, MN
  • NPI 1689454951
  Medicare reassignment NPD Authorized official
• Wild Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Fridley, MN
  • NPI 1780485854
  NPD (past)

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1174277727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2589 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 205C",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325176",
            "telephone_number": "763-244-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CAMILLE",
        "credential": "MA, LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC03175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara N Jama
• Dechen C Jamling, BSN RN
• Daniel M Janiga, MD MPH
• Jannah Health Services, LLC
• Jasira Family Counseling
• Abdulhamid Hassan Jibrell
• Sundus Hussein Jibrill
• Catherine Rose Johanneck, M.S.W. L.I.C.S.W
• Paula Jean Johns, RN
• Amber M Johnson, PA

• Professional Counselor in Fridley, MN
• Providers in Fridley, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.