Provider Demographics
NPI:1740620558
Name:JENSEN, BRANDON JAMES (LMFT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMES
Last Name:JENSEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 12TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-2317
Mailing Address - Country:US
Mailing Address - Phone:320-282-8868
Mailing Address - Fax:
Practice Address - Street 1:303 4TH AVE S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4728
Practice Address - Country:US
Practice Address - Phone:320-282-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2592106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist