Provider Demographics
NPI:1184096315
Name:PATRICIA L. JENSEN, LMFT
Entity type:Organization
Organization Name:PATRICIA L. JENSEN, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE & FAMILY THERAPIS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:516-445-5191
Mailing Address - Street 1:1600 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2330
Mailing Address - Country:US
Mailing Address - Phone:516-445-5191
Mailing Address - Fax:
Practice Address - Street 1:1600 FRONT ST
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2330
Practice Address - Country:US
Practice Address - Phone:516-445-5191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty