Provider Demographics
NPI:1417641721
Name:JENSEN, AMANDA KAY (MA, NCMHC, TLMHC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAY
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MA, NCMHC, TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 240TH ST
Mailing Address - Street 2:
Mailing Address - City:RINGSTED
Mailing Address - State:IA
Mailing Address - Zip Code:50578-7554
Mailing Address - Country:US
Mailing Address - Phone:507-995-9891
Mailing Address - Fax:
Practice Address - Street 1:201 E 11TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4460
Practice Address - Country:US
Practice Address - Phone:800-242-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA120206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health