Sumre Michelle Jensen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

104379 Issued in TX

Practice address

1631 E 2ND St
Austin, TX 78702-4490

Phone

(501) 804-3627

NPI assigned

Jul 16, 2013

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

Medicare fee-for-service enrollment

Enrolled in TX

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Travis County Mental Health and Mental Retardation CenterGroup PAC ID 9133016306, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Austin Travis County Mental Health and Mental Retardation Center

  • Psychiatry Physician
  • Austin, TX
  • NPI 1750337259

  Clinical

  Medicare reassignment Care Compare group NPD
• Austin Travis County Mental Health and Mental Retardation Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Austin, TX
  • NPI 1053632505
  NPD
• Inspiration Day Treatment, Inc.

  • Community/Behavioral Health Agency
  • Little Rock, AR
  • NPI 1811141807
  NPD (past)

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1760823926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 E 2ND ST STE C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024491",
            "telephone_number": "512-804-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 E 2ND ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024490",
            "telephone_number": "501-804-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SUMRE",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Yuri Jensen, M.D.
• Jill Jensen
• Justin Natali Jensen
• Kylie Jensen, RRT
• Regina Jensen, DDS
• Thomas Jensen Jr.
• Anita Jenson, RPH
• Grace Jeong
• Jepson Medical Affiliates PA
• Jepson Wellness Group LLC

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.