Jean Ann Christensen, PSY D, LP, LICSW

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3903 Issued in MN

Practice address

403 4TH St NW
Suite 245
Bemidji, MN 56601-3142

Phone

(218) 444-6912

Fax

(218) 444-6937

NPI assigned

Sep 22, 2006

Last updated

Mar 31, 2009By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Great River Psychological Services, P.a.

  • Psychologist
  • Bemidji, MN
  • NPI 1952544934
  Authorized official Same address or phone

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1346340247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW",
            "address_2": "SUITE 245",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013142",
            "telephone_number": "218-444-6912",
            "fax_number": "218-444-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW",
            "address_2": "SUITE 245",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013142",
            "telephone_number": "218-444-6912",
            "fax_number": "218-444-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY D, LP, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3903",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "6212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "992757300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Germaine E Cheslock, O.D.
• Charles J Chmielewski, PH.D., L.P.
• Anna Chock
• Choice Therapy
• Choice Therapy, P.a.
• Sally Christensen
• Chantal Cherise Christofferson, BS
• Grant M Christopher, MD
• Antony Fu-Chin Chu, MD
• Scott Andre Cirks, MPT

• Psychologist in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.