Provider Demographics
NPI:1598297863
Name:JENSEN, DEBORAH JOY
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JOY
Last Name:JENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:JENSEN
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:21 CHARLES ST.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06824
Mailing Address - Country:US
Mailing Address - Phone:203-257-6610
Mailing Address - Fax:
Practice Address - Street 1:21 CHARLES ST
Practice Address - Street 2:SUITE 120
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5803
Practice Address - Country:US
Practice Address - Phone:203-257-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist