Provider Demographics
NPI:1679971253
Name:JENSEN, REBEKAH N (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:N
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:JC
Other - Last Name:NIEDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:13751 HILL CREST CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9143
Mailing Address - Country:US
Mailing Address - Phone:317-975-1040
Mailing Address - Fax:
Practice Address - Street 1:13751 HILL CREST CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9143
Practice Address - Country:US
Practice Address - Phone:317-975-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-12
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0189161041C0700X
IN34007622A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical