Provider Demographics
NPI:1821518754
Name:JENSEN, KALI ANN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9248 MORNING SIDE DR NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9230
Mailing Address - Country:US
Mailing Address - Phone:360-434-3064
Mailing Address - Fax:
Practice Address - Street 1:225 NW LINDVIG WAY STE 7
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9090
Practice Address - Country:US
Practice Address - Phone:360-434-3064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60757344101YM0800X
WALH61176883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health