Healthcare Provider Details

I. General information

NPI: 1306336060
Provider Name (Legal Business Name): SONJA N JOSSELYN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 GENDER RD
CANAL WINCHESTER OH
43110-8451
US

IV. Provider business mailing address

89 OBERLE AVE
CARROLL OH
43112-9765
US

V. Phone/Fax

Practice location:
  • Phone: 888-891-8567
  • Fax: 614-386-5108
Mailing address:
  • Phone: 888-891-8567
  • Fax: 614-386-5108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2102408
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1801010
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: