Healthcare Provider Details

I. General information

NPI: 1134579840
Provider Name (Legal Business Name): JOSIE OSBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

764 E 100 N
PAYSON UT
84651-2345
US

IV. Provider business mailing address

68 NORTH FRONT ST
NEW BEDFORD MA
02740
US

V. Phone/Fax

Practice location:
  • Phone: 801-655-5450
  • Fax:
Mailing address:
  • Phone: 774-213-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9071741
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC11493
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8339654-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: