Provider Demographics
NPI:1811325509
Name:JENSEN, MERRITT M (PHD)
Entity type:Individual
Prefix:DR
First Name:MERRITT
Middle Name:M
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CONSHOHOCKEN STATE RD
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1335
Mailing Address - Country:US
Mailing Address - Phone:610-665-3456
Mailing Address - Fax:
Practice Address - Street 1:311 CONSHOHOCKEN STATE RD
Practice Address - Street 2:
Practice Address - City:GLADWYNE
Practice Address - State:PA
Practice Address - Zip Code:19035-1335
Practice Address - Country:US
Practice Address - Phone:610-665-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015434103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent