MEDICARE: JODY OSSI MSE, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5502-125	WI

General Provider Information

NPI Number	:	1558612291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODY OSSI MSE, LPC

Provider Business Mailing Address
First Line	:	504 LAKELAND RD
Second Line	:
City	:	SHAWANO
State	:	WI
Zip	:	54166-3836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3760 SHAWANO AVE APT 44
Second Line	:
City	:	HOWARD
State	:	WI
Zip	:	54313-7459
Country	:	US
Telephone Number	:	608-885-0901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2012
Last Update Date	:	02/21/2025

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