Individual provider Active NPI

Eric Jensema

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1801713433
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
702 N Blackhawk Ave Ste 215
Madison, WI 53705-3357
Phone
(608) 235-5775
NPI assigned
Jul 3, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

702 N Blackhawk Ave Ste 215
Madison, WI 53705-3357

Mailing address

205 Breunig Blvd
Waunakee, WI 53597-8738
Phone (608) 235-5775

Other practice location 1

205 Breunig Blvd
Waunakee, WI 53597-8738
Phone (608) 235-5775

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

NPI Registry JSON

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

{
    "created_epoch": "1783036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1801713433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BREUNIG BLVD",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535978738",
            "telephone_number": "608-235-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE STE 215",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "608-235-5775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Breunig Blvd",
            "address_purpose": "LOCATION",
            "city": "Waunakee",
            "state": "WI",
            "postal_code": "535978738",
            "country_code": "US",
            "telephone_number": "608-235-5775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEMA",
        "first_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-03",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.