Provider Demographics
NPI:1346022100
Name:JENSEN, TAMRA JEAN (LICSW)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:JEAN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TAMRA
Other - Middle Name:
Other - Last Name:STORMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24881 COUNTY ROAD 5 NW
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-9656
Mailing Address - Country:US
Mailing Address - Phone:320-248-8362
Mailing Address - Fax:
Practice Address - Street 1:301 BECKER AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3302
Practice Address - Country:US
Practice Address - Phone:320-235-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN287461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical