Individual provider Active NPI

Kathryn Leone Jensen, PHD

  • Psychologist
  • Pittsfield, MA
National Provider Identifier
1205994563
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4011 Issued in MA
Practice address
150 North St
Ste 39D
Pittsfield, MA 01201-5173
Phone
(413) 499-9994
Fax
(413) 499-5994
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4011 MA Primary

Addresses

Primary practice location

150 North St
Ste 39D
Pittsfield, MA 01201-5173

Mailing address

150 North St
Ste. 39D
Pittsfield, MA 01201-5173
Phone (413) 499-9994

Other identifiers 3

IdentifierTypeStateIssuer
12768300OtherMAGELLAN
141200OtherTUFTS
367586OtherMVP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4011MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center in the Berkshires Inc PastSince Mar 3, 2011 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1205994563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NORTH ST",
            "address_2": "STE. 39D",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015173",
            "telephone_number": "413-499-9994",
            "fax_number": "413-499-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NORTH ST",
            "address_2": "STE 39D",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015173",
            "telephone_number": "413-499-9994",
            "fax_number": "413-499-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KATHRYN",
        "middle_name": "LEONE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "12768300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "141200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "367586",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.