Provider Demographics
NPI:1780468686
Name:JENSEN, JULIE LYNN (MS MFT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7633 GANSER WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2092
Mailing Address - Country:US
Mailing Address - Phone:608-688-3200
Mailing Address - Fax:
Practice Address - Street 1:7633 GANSER WAY STE 200
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2092
Practice Address - Country:US
Practice Address - Phone:608-688-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2252-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist