Provider Demographics
NPI:1407733454
Name:CHRISTENSEN, JENNIFER (EDS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16314 HIMEBAUGH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3703
Mailing Address - Country:US
Mailing Address - Phone:402-490-9779
Mailing Address - Fax:
Practice Address - Street 1:11620 N 156TH ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-5401
Practice Address - Country:US
Practice Address - Phone:402-238-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3086677321103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool