Nicole F Jensen, LPC | |
2424 S 90th St, West Allis, WI 53227-2455 | |
(414) 773-4312 | |
(414) 329-5637 |
Full Name | Nicole F Jensen |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 2424 S 90th St, West Allis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023276417 | NPI | - | NPPES |
43593900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3639 (Wisconsin) | Secondary |
101YM0800X | Counselor - Mental Health | 3639 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
---|---|
Nicole F Jensen, LPC Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Nicole F Jensen, LPC 2424 S 90th St, West Allis, WI 53227-2455 Ph: (414) 773-4312 |
Nicholas Paul Hayon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10201 W Lincoln Ave, Suite 102, West Allis, WI 53227 Phone: 414-546-6880 Fax: 414-546-6891 | |
Lashawna Thomas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2814 S 108th St, West Allis, WI 53227 Phone: 414-885-3525 Fax: 262-643-4617 | |
Ashley A Mitchell, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2814 S 108th St, West Allis, WI 53227 Phone: 414-885-3525 | |
Charity Walsh, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1205 S 70th St, Ste 301, West Allis, WI 53214 Phone: 414-475-2788 | |
Mr. Christian Lamarr Lemmie, LPC, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2424 S 102nd St, West Allis, WI 53227 Phone: 414-203-4514 | |
Grace Ellul, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10150 W National Ave Ste 390, West Allis, WI 53227 Phone: 414-545-4430 |