Individual provider Active NPI

Lesley Jensen Jensen, LICSW

  • Clinical Social Worker
  • Waconia, MN
National Provider Identifier
1275482861
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16704 Issued in MN
Practice address
500 S Maple St
Waconia, MN 55387-1752
Phone
(952) 442-2191
Fax
(952) 442-6044
NPI assigned
Jan 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16704 MN Primary

Addresses

Primary practice location

500 S Maple St
Waconia, MN 55387-1752

Mailing address

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260324003579 MN Practitioner - Clinical Social Worker 7911481254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 S Maple St
Waconia, MN 55387-1752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16704MNMDClinical Social Worker

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": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1275482861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LESLEY",
        "middle_name": "JENSEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.