Individual
NICOLE F JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2424 S 90TH ST, WEST ALLIS, WI 53227-2455
(414) 773-4312
(414) 329-5637
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3639
WI
101YP2500X
Professional Counselor
3639
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43593900
—
WI
Enumeration date
06/02/2008
Last updated
06/26/2024
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