Individual
MR. GREGORY VERNON JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
205 E UNIVERSITY AVE, SUITE 200, GEORGETOWN, TX 78626-6814
(877) 800-5722
(512) 257-1763
Mailing address
205 E UNIVERSITY AVE, SUITE 300, GEORGETOWN, TX 78626-6814
(877) 800-5722
(512) 257-1763
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
53941
TX
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215422101
—
TX
Enumeration date
05/22/2007
Last updated
04/01/2014
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