Provider Demographics
NPI:1194368860
Name:JENSEN, ANINE PATRICE (MS ED, LPCC)
Entity Type:Individual
Prefix:
First Name:ANINE
Middle Name:PATRICE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MS ED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST STE 402
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1726
Mailing Address - Country:US
Mailing Address - Phone:218-726-5433
Mailing Address - Fax:218-279-2844
Practice Address - Street 1:324 W SUPERIOR ST STE 402
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1726
Practice Address - Country:US
Practice Address - Phone:218-726-5433
Practice Address - Fax:218-279-2844
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional