Healthcare Provider Details

I. General information

NPI: 1487082350
Provider Name (Legal Business Name): PATRICK OSBORNE LSCSW, LCMFT, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2013
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E FIRST ST
NEWTON KS
67114-5010
US

IV. Provider business mailing address

PO BOX 467
NEWTON KS
67114-0467
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-6400
  • Fax: 316-284-6490
Mailing address:
  • Phone: 316-284-6400
  • Fax: 316-284-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1326
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4796
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4796
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2866
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: