Jensen, Gerald Edward
Jensen, Gerald Edward is an sole proprietor health care provider with primary practice located at 2155 Antler Dr Sw , Brainerd MN 56401-2589. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Jensen, Gerald Edward can be contacted via phone (218) 822-3736.Contact Information
Primary practice address
2155 Antler Dr Sw
Brainerd MN 56401-2589
Phone: (218) 822-3736
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP4642 | Minnesota |
Profile Details
| NPI number | 1265435937 |
|---|---|
| LBN Legal business name | Jensen, Gerald Edward |
| Credentials | MA, LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Feb 6th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265435937 | NPPES |
| Minnesota | Other | LP4642 | MN PSYCHOLOGY LICENSE |
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