Active NPI
Sophia Jensen, LCPC
- Mental Health Counselor
- Missoula, MT
National Provider Identifier
1558025924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- BBH-PCLC-LIC-50035
- Practice address
- 128 S 5TH St W
Missoula, MT 59801-2714 - Phone
- (541) 261-9772
- NPI assigned
- Oct 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | BBH-PCLC-LIC-50035 | MT | Primary |
Addresses
Primary practice location
128 S 5TH St W
Missoula, MT 59801-2714
Mailing address
413 Oak St
Missoula, MT 59801-2323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 8, 2024 through Mar 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-PCLC-LIC-50035 | MT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1558025924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 OAK ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598012323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 S 5TH ST W",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598012714",
"telephone_number": "541-261-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "SOPHIA",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-22",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "BBH-PCLC-LIC-50035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.