Katelyn Jensen, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27513 Issued in MD

Practice address

22655 Washington St
Leonardtown, MD 20650-3848

Phone

(301) 690-8008

NPI assigned

May 31, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katelyn Tippett Former name

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Serenity Place, LLC

  • Community/Behavioral Health Agency
  • Leonardtown, MD
  • NPI 1467998468

  Clinical

  NPD

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1518533686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1831",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206501831",
            "telephone_number": "301-690-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22655 WASHINGTON ST",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503848",
            "telephone_number": "301-690-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KATELYN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-31",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "27513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "TIPPETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James P Dabbs DDS PA
• Catherine James
• Heather Marie Jarrett, PTA
• Heather Renee Jefferson, CRNP
• Laura Elizabeth Jennings, LMSW
• Calvin Johnson Jr., CAC-AD
• Donna Johnson, BSN,MS,CRNP
• Kaitlin Johnson, LMSW
• Sarah Anne Johnson, MD
• Peter Shay Johnston, MD

• Clinical Social Worker in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.