Jensen, Gregory Vernon

Jensen, Gregory Vernon is an individual health care provider with primary practice located at 205 E University Ave Suite 200, Georgetown TX 78626-6814. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jensen, Gregory Vernon can be contacted via phone (877) 800-5722.

Contact Information

Primary practice address
205 E University Ave Suite 200 Georgetown TX 78626-6814
Phone: (877) 800-5722
Fax: (512) 257-1763
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 53941 Texas

Profile Details

NPI number 1700096724
LBN Legal business name Jensen, Gregory Vernon
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Apr 1st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700096724 NPPES
Texas MEDICAID 215422101

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