Provider Demographics
NPI:1205651270
Name:JENSEN, KAREN (MA, CAS, NCSP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MA, CAS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7816
Mailing Address - Country:US
Mailing Address - Phone:240-439-9399
Mailing Address - Fax:
Practice Address - Street 1:191 S EAST ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5918
Practice Address - Country:US
Practice Address - Phone:240-439-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool