Individual provider Active NPI

Lisa Ann Jensen, LCPC

  • Professional Counselor
  • Rochelle, IL
National Provider Identifier
1912387754
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.008416 Issued in IL
Practice address
PO Box 364
Rochelle, IL 61068-0364
Phone
(815) 751-5790
NPI assigned
Jun 7, 2015
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.008416 IL Primary

Addresses

Primary practice location

PO Box 364
Rochelle, IL 61068-0364

Mailing address

PO Box 364
Rochelle, IL 61068-0364
Phone (815) 751-5790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240827001037 IL Practitioner - Mental Health Counselor 9436698180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Changes Counseling, LLCGroup PAC ID 9032531769, 3 clinicians

Practice addresses (Care Compare)

604 N Main St
Suite 4
Rochelle, IL 61068-1686
Phone (815) 501-2088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.008416ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Changes Counseling, LLC Professional CurrentSince Jun 27, 2024 Accepting new patients

Locations

121 S 4th St
Oregon, IL 61061
Phone (815) 501-2088

400 5th St
Ste 190
Peru, IL 61354
Phone (815) 501-2088

604 N Main St
Ste 4
Rochelle, IL 61068
Phone (815) 501-2088

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1912387754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610680364",
            "telephone_number": "815-751-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610680364",
            "telephone_number": "815-751-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-07",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle, IL

Sources for this page

Verify at the official NPI Registry.