Melissa A Jensen, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

907 N Bluff Rd Ste 9
Collinsville, IL 62234-5816

Phone

(618) 345-9644

Fax

(618) 345-6577

NPI assigned

Jul 2, 2018

Last updated

Jul 2, 2018By the provider in NPPES

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

Other names 1

• Melissa Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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

• One Hope United

  • Community/Behavioral Health Agency
  • Collinsville, IL
  • NPI 1902161052
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1760978829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E HIGH ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251627",
            "telephone_number": "618-345-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N BLUFF RD STE 9",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622345816",
            "telephone_number": "618-345-9644",
            "fax_number": "618-345-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "WALLACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• HW Holdings (All About Eyes)
• Ashley Marie Hynes, PA-C
• Samantha Rae Jackson, FNP-BC
• James F. Strieter, OD, PC (Family Eye Clinic)
• James J. Stehman, D.M.D., P.C.
• John E Forhetz PHD
• Johnnie Faye Johnson, MEDICAL ASSISTANT
• Janae Cambriel Jones, PTA
• Shonika Deneen Jones
• Ryan A Jouett, LCPC, LPC

• Mental Health Counselor in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.