Lisa R Jensen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11713 Issued in MN

Practice address

600 25TH Ave S
Suite 109
Saint Cloud, MN 56301-4841

Phone

(320) 255-0343

Fax

(320) 654-0318

NPI assigned

Sep 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1730338013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S",
            "address_2": "SUITE 109",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014841",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S",
            "address_2": "SUITE 109",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014841",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "11713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin S Jenner, M.D.
• Kelli Jo Jensch, RD, LD
• Jaime Lynne Jensen
• Joyce C Jensen, CRNA
• Kayla Marie Jensen, MSN, RN, PHN
• Marissa M Jensen, LPCC
• Samantha Jensen, OTR/L
• Tanya Ann Jensen
• Alexandra Jae Jenson, PHARM. D
• Joseph John Jerkovich, BC-HIS

• All providers in Saint Cloud, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.