Healthcare Provider Details

I. General information

NPI: 1083534903
Provider Name (Legal Business Name): ISAAC ANDERSON BOSCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 1ST AVE NW STE 201
HICKORY NC
28601-6161
US

IV. Provider business mailing address

1030 CEDAR HILLS CT SE APT H
LENOIR NC
28645-6918
US

V. Phone/Fax

Practice location:
  • Phone: 828-855-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023781
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: