Individual
THAD MICHAEL JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LPCC, LMHC
Contact information
Practice address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(651) 213-4779
Mailing address
463 PALM TREE DR, BRADENTON, FL 34210-3063
(612) 221-2858
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305429
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
MCAP.0100806
FL
101YM0800X
Mental Health Counselor
Primary
3346
MN
101YM0800X
Mental Health Counselor
MH21654
FL
Other
Enumeration date
03/09/2020
Last updated
08/02/2023
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