Provider Demographics
NPI:1134932411
Name:JENSON, SCOTT (RMHCI)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:JENSON
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 E RIVER DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7839
Mailing Address - Country:US
Mailing Address - Phone:813-416-2573
Mailing Address - Fax:
Practice Address - Street 1:1111 N WEST SHORE BLVD STE 213
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4711
Practice Address - Country:US
Practice Address - Phone:813-416-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5431863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health