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Shane Jensen
Addiction (Substance Use Disorder) Counselor in Minneapolis, Minnesota
NPI 1053966069

Shane Jensen is an Addiction (Substance Use Disorder) Counselor based in Minneapolis, MN and is specialized in Addiction (Substance Use Disorder). Shane Jensen practices in Minneapolis, MN. The NPI Number for Shane Jensen is 1053966069 and holds a License No. 304481 (Minnesota).

The current practice location address for Shane Jensen is 610 22Nd Ave S, Minneapolis, MN and can be reached out via phone at 612-330-1170.

Location: 610 22Nd Ave S, Minneapolis, MN, 55454-1315
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053966069
Provider Name
Shane Jensen
Credential
Provider Entity Type
Individual
Gender
Male
Address
610 22Nd Ave S, Minneapolis, MN, 55454-1315
Phone Number
612-330-1170
Fax Number
Provider Enumeration Date
08/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
610 22Nd Ave S
City
Minneapolis
State
Minnesota
Zip
55454-1315
Phone Number
612-330-1170
Fax Number
person
Provider Business Mailing Address Details
Address
610 22Nd Ave S
City
Minneapolis
State
Minnesota
Zip
55454-1315
Phone Number
612-330-1170
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
304481 (Minnesota)
Definition
Definition to come...
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