Mariam A Jensen, LCMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2997 Issued in KS

Practice address

2420 N Woodlawn Blvd
BLDG 100 Ste K
Wichita, KS 67220-3960

Phone

(316) 779-4337

Fax

(316) 776-4509

NPI assigned

Aug 9, 2017

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

Other identifiers 1

Other names 1

• Mariam A Mikhael Former name

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1740705995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 N WOODLAWN BLVD",
            "address_2": "BLDG 100 STE K",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203960",
            "telephone_number": "316-779-4337",
            "fax_number": "316-776-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 N WOODLAWN BLVD",
            "address_2": "BLDG 100 STE K",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203960",
            "telephone_number": "316-779-4337",
            "fax_number": "316-776-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MARIAM",
        "middle_name": "A",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201165860B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAM",
            "last_name": "MIKHAEL",
            "middle_name": "A",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daran L Jensen, MD
• Heidi Marie Jensen, LP
• Jennifer Whitney Jensen, APRN
• Jonathan Andrew Jensen, M.D.
• Kayla Marie Jensen, PA
• Rachel Jensen, ATC
• Susan A Jensen, D.C.
• Sarah Jeon
• David A Jernigan, DC
• Taylor Phillip Jerominski, DDS

• Marriage & Family Therapist in Wichita, KS
• Providers in Wichita, KS by specialty
• Marriage & Family Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.