John Victor Jensen, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17811 Issued in NC

Practice address

5411 Ramsey St
Fayetteville, NC 28311-1424

Phone

(910) 688-3534

NPI assigned

Dec 13, 2022

Last updated

Mar 28, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Woodhaven Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fayetteville, NC
  • NPI 1083465017
  NPD Authorized official
• Woodhaven Counseling PLLC

  • Mental Health Counselor
  • Fayetteville, NC
  • NPI 1134917677
  NPD Authorized official

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1184335879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SWAN ISLAND CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283118947",
            "telephone_number": "910-229-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111424",
            "telephone_number": "910-688-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JOHN",
        "middle_name": "VICTOR",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "17811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.jensen@woodhavencounseling.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5411 Ramsey St",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283111424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Main Jenks, LICENSED MASS.TH.
• Millicent Calena Jennette, PA-C
• Julianna Jennings
• Jenny & Marv's Transportation Angels
• Blanche Coleman Jensen
• Jeremiah C Davis, DDS, Mba, PA (The Teeth Doctors)
• Jerome V Ponder MD PC
• Dildra Jessup, LPCA
• Mirae Jessup
• Pamela Hendrick Jessup, M.D.

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.