Provider Demographics
NPI:1043805468
Name:JENSEN, KATELYN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 S HANLEY RD STE 504
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3415
Mailing Address - Country:US
Mailing Address - Phone:314-441-6605
Mailing Address - Fax:
Practice Address - Street 1:200 S HANLEY RD STE 504
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3415
Practice Address - Country:US
Practice Address - Phone:314-441-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker