Theresa Michel Jensen, LPN CAC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2878 Issued in CO

Practice address

650 East Walnut
Elizabeth, CO 80107

Phone

(303) 646-4519

Fax

(970) 522-4211

NPI assigned

May 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Theresa Michel Huston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1316105695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W MAIN ST",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807513168",
            "telephone_number": "970-522-4549",
            "fax_number": "970-522-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EAST WALNUT",
            "city": "ELIZABETH",
            "state": "CO",
            "postal_code": "80107",
            "telephone_number": "303-646-4519",
            "fax_number": "970-522-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "THERESA",
        "middle_name": "MICHEL",
        "credential": "LPN CAC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "2878",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CO",
            "license": "15108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "HUSTON",
            "middle_name": "MICHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lisa Jennings-Clark, MA
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• Addiction (Substance Use Disorder) Counselor in Elizabeth, CO
• Providers in Elizabeth, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.