Provider Demographics
NPI:1225151392
Name:JENSEN HINCHEE, KATHLEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:JENSEN HINCHEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1509 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:PANACEA
Mailing Address - State:FL
Mailing Address - Zip Code:32346-2159
Mailing Address - Country:US
Mailing Address - Phone:850-984-5283
Mailing Address - Fax:850-984-4467
Practice Address - Street 1:1509 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:PANACEA
Practice Address - State:FL
Practice Address - Zip Code:32346-2159
Practice Address - Country:US
Practice Address - Phone:850-984-5283
Practice Address - Fax:850-984-4467
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2020-07-15
Deactivation Date:2017-02-22
Deactivation Code:
Reactivation Date:2020-07-15
Provider Licenses
StateLicense IDTaxonomies
FLSW82731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical