Provider Demographics
NPI:1013253475
Name:JENSEN, LAUREN RAISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RAISSA
Last Name:JENSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:RAISSA
Other - Last Name:KINDSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1135
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80402-1135
Mailing Address - Country:US
Mailing Address - Phone:720-791-2368
Mailing Address - Fax:
Practice Address - Street 1:5942 CULEBRA CT
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-1010
Practice Address - Country:US
Practice Address - Phone:720-791-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical