Samantha Jensen, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-204995 Issued in WI

Practice address

KGH Consultation and Treatment Inc.,
3113 West Beltline Hwy
Madison, WI 53713

Phone

(608) 819-6910

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• KGH Consultation & Treatment, Inc.

  dba KGH Autism Services

  • Behavior Analyst
  • Deerfield, IL
  • NPI 1073840740

  Behavior Technician

  NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1962142075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KGH CONSULTATION AND TREATMENT INC",
            "address_2": "1161 LAKE COOK ROAD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "224-284-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KGH CONSULTATION AND TREATMENT INC.,",
            "address_2": "3113 WEST BELTLINE HWY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53713",
            "telephone_number": "608-819-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SAMANTHA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WI",
            "license": "RBT-22-204995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Jensen, LMFT
• Kristie A Jensen
• Laury Lynn Jensen, RN
• Matthew Jensen, PHARMD
• Norman M Jensen, MD MS
• Tanya Jensen, M.S., CCC-SLP
• Vivian B Jensen
• Wendy Jensen
• Anna Catherine Jenson
• Melinda Jane Jenson, RN

• Behavior Technician in Madison, WI
• Providers in Madison, WI by specialty
• Behavior Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.