Provider Demographics
NPI:1588842264
Name:JENSEN, BARBARA ANN (MA, LP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3754 PLEASANT AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1279
Mailing Address - Country:US
Mailing Address - Phone:612-242-1007
Mailing Address - Fax:
Practice Address - Street 1:3754 PLEASANT AVE STE 205
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1279
Practice Address - Country:US
Practice Address - Phone:612-242-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2363103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN488250400OtherMINNESOTA DHS