Individual provider Active NPI

Sheli K Jensen, MAS MFT, LMFT

  • Marriage & Family Therapist
  • Mesa, AZ
National Provider Identifier
1982155503
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
15163 Issued in AZ
Practice address
1930 S Alma School Rd Ste C105
Mesa, AZ 85210-3067
Phone
(480) 826-3537
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 15163 AZ Primary

Addresses

Primary practice location

1930 S Alma School Rd Ste C105
Mesa, AZ 85210-3067

Mailing address

303 E Fremont Dr
Tempe, AZ 85282-6933
Phone (602) 931-5501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240724004397 AZ Practitioner - Marriage and Family Therapist 8527409762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1930 S Alma School Rd
Suite C105
Mesa, AZ 85210-3067
Phone (480) 826-3537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15163AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agave Center for Behavioral Health PLLC Marriage & Family Therapist CurrentSince Feb 27, 2024 Accepting new patients

Locations

1930 S Alma School Rd
Ste C105
Mesa, AZ 85210
Phone (480) 645-3177

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1982155503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E FREMONT DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826933",
            "telephone_number": "602-931-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S ALMA SCHOOL RD STE C105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103067",
            "telephone_number": "480-826-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SHELI",
        "middle_name": "K",
        "credential": "MAS MFT, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "15163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.