Provider Demographics
NPI:1518235324
Name:JENSEN, NOELLE K (LCSW)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:K
Last Name:JENSEN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2009
Mailing Address - Country:US
Mailing Address - Phone:908-217-6748
Mailing Address - Fax:
Practice Address - Street 1:88 PARK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5915
Practice Address - Country:US
Practice Address - Phone:908-217-6748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054257001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC05425700OtherLICENSED CLINICAL SOCIAL WORKER