Provider Demographics
NPI:1205852175
Name:JENSEN, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 RIDINGS WAY
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5246
Mailing Address - Country:US
Mailing Address - Phone:215-641-1616
Mailing Address - Fax:
Practice Address - Street 1:725 SKIPPACK PIKE
Practice Address - Street 2:SUITE 335
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1741
Practice Address - Country:US
Practice Address - Phone:215-641-1616
Practice Address - Fax:425-699-8368
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006786L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling