Provider Demographics
NPI:1679877104
Name:THOMAS JENSEN
Entity Type:Organization
Organization Name:THOMAS JENSEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:702-646-6284
Mailing Address - Street 1:7310 SMOKE RANCH RD STE R
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0260
Mailing Address - Country:US
Mailing Address - Phone:702-646-6284
Mailing Address - Fax:702-646-6284
Practice Address - Street 1:7310 SMOKE RANCH RD STE R
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0260
Practice Address - Country:US
Practice Address - Phone:702-646-6284
Practice Address - Fax:702-646-6284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty