Provider Demographics
NPI:1902584501
Name:WOELFLE, JENSEN COWELL (LCMHCA)
Entity Type:Individual
Prefix:
First Name:JENSEN
Middle Name:COWELL
Last Name:WOELFLE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N GREENSBORO ST STE C6
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1849
Mailing Address - Country:US
Mailing Address - Phone:919-843-9989
Mailing Address - Fax:
Practice Address - Street 1:200 N GREENSBORO ST STE C6
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1849
Practice Address - Country:US
Practice Address - Phone:919-843-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18960101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health