Kelly Jensen

Primary specialty

Social WorkerTaxonomy code 104100000X

License

1627 Issued in ND

Practice address

314 5TH St W
Ste. 1
Bottineau, ND 58318-1204

Phone

(701) 228-3613

Fax

(701) 228-3600

NPI assigned

Apr 29, 2014

Last updated

Apr 29, 2014By 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 1

Addresses

Other names 1

• Kelly Clauson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bottineau County Social Services

  • Case Management Agency
  • Bottineau, ND
  • NPI 1447660261
  NPD (past) Authorized official

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1548670698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 5TH ST W",
            "address_2": "STE. 1",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181204",
            "telephone_number": "701-228-3613",
            "fax_number": "701-228-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 5TH ST W",
            "address_2": "STE. 1",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181204",
            "telephone_number": "701-228-3613",
            "fax_number": "701-228-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "1627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CLAUSON",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristy Hennings
• Ryan M Henry, LICSW
• Dean Herman
• Leah S. Hermanson-Faul
• J & J Enterprises Inc (Thompson Drug)
• Evelyn Johnson
• Amy Lee Kester-Mabon, RN
• Jennifer Jolene Kittleson
• Kathleen Kittleson
• Kyleen Kitzman

• Social Worker in Bottineau, ND
• Providers in Bottineau, ND by specialty
• Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.