Active NPI
Cassidy Jensen
- Professional Counselor
- Derby, KS
National Provider Identifier
1780314237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC03919
- Practice address
- 1221 N Rock Rd
Derby, KS 67037-3678 - Phone
- (316) 747-5072
- NPI assigned
- Jun 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | LCPC03919 | KS | |
| Professional Counselor | 101YP2500X | LCPC03919 | KS | Primary |
Addresses
Primary practice location
1221 N Rock Rd
Derby, KS 67037-3678
Mailing address
106 E Creekstone St
Mulvane, KS 67110-9269
Phone (785) 201-4666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC03919 | KS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1780314237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 E CREEKSTONE ST",
"city": "MULVANE",
"state": "KS",
"postal_code": "671109269",
"telephone_number": "785-201-4666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 N ROCK RD",
"city": "DERBY",
"state": "KS",
"postal_code": "670373678",
"telephone_number": "316-747-5072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "CASSIDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-15",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "KS",
"license": "LCPC03919",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "LCPC03919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.