Denise Jensen, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008473A Issued in IN

Practice address

12306 Goldeneyes CT
Fort Wayne, IN 46845-9160

Phone

(574) 304-3661

NPI assigned

Oct 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1669757225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12306 GOLDENEYES CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459160",
            "telephone_number": "574-304-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12306 GOLDENEYES CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459160",
            "telephone_number": "574-304-3661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 College Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265111",
            "country_code": "US",
            "telephone_number": "574-304-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DENISE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33004892A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008473A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jennings
• Jennifer M Jennings
• Mackenzie Ann Jennings
• Randy James Jennings
• Samantha Dawn Jennings
• Mariah Kimberly Ann Jensen
• Jericho Partners, LLC
• Tania Jesmine, M.D.
• Jesse Blair DDS LLC
• Jessica a. Zimmerman LMHC LLC

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.