Individual provider Active NPI

James William Jensen, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1902120801
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R016718-1 Issued in NY
Practice address
163 W 125TH St
12TH Floor
New York, NY 10027-4436
Phone
(212) 961-8711
Fax
(212) 866-2760
NPI assigned
Mar 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R016718-1 NY Primary
Clinical Social Worker 1041C0700X R018716-1 NY

Addresses

Primary practice location

163 W 125TH St
12TH Floor
New York, NY 10027-4436

Mailing address

163 W 125TH St
12TH Floor
New York, NY 10027-4436
Phone (212) 961-8711

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

LicenseStateTypeSpecialty
R016718-1NYMDClinical Social Worker
R018716-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1902120801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 W 125TH ST",
            "address_2": "12TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274436",
            "telephone_number": "212-961-8711",
            "fax_number": "212-866-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 W 125TH ST",
            "address_2": "12TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274436",
            "telephone_number": "212-961-8711",
            "fax_number": "212-866-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R016718-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R018716-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.