Individual provider Active NPI

Kathy F Jensen, LCSW

  • Clinical Social Worker
  • Boulder City, NV
National Provider Identifier
1841264082
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2678C Issued in NV
Practice address
916 Nevada Highway
#3
Boulder City, NV 89005
Phone
(702) 294-2866
Fax
(702) 294-3073
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2678C NV Primary

Addresses

Primary practice location

916 Nevada Highway
#3
Boulder City, NV 89005

Mailing address

916 Nevada Highway
#3
Boulder City, NV 89005
Phone (702) 294-2866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20040419000167 NV Practitioner - Clinical Social Worker 5193719458 Reassigns benefits to 1 organization
Practice locations: Boulder City, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspire Therapeutic Solutions LLCGroup PAC ID 5294010377, 2 clinicians

Practice addresses (Care Compare)

1017 E Basin Ave
Suite 3
Pahrump, NV 89060-4532
Phone (775) 751-0444

119 Caperna CT
Boulder City, NV 89005-1294
Phone (702) 293-2345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2678CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Therapeutic Solutions LLC CurrentSince Aug 19, 2017 Accepting new patients
Magdalene Clinical Consulting, Inc. PastSince Aug 19, 2017 Accepting new patients

Locations

1017 E Basin Ave
Ste 3
Pahrump, NV 89060
Phone (775) 513-6900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1841264082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 NEVADA HIGHWAY",
            "address_2": "#3",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "89005",
            "telephone_number": "702-294-2866",
            "fax_number": "702-294-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 NEVADA HIGHWAY",
            "address_2": "#3",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "89005",
            "telephone_number": "702-294-2866",
            "fax_number": "702-294-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KATHY",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2678C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

Verify at the official NPI Registry.