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General NPI Number Information
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NPI Number | 1073842548
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Entity Type | Individual
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Provider Name | JON E BOSCHEN LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/13/2009
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Last Update Date | 01/24/2026
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Provider Practice Location Address
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Address Line | 210 MAIN ST
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City | PITTSFIELD
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State | ME
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Zip | 04967-4362
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Country | US
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Telephone | 862-432-9149
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Fax |
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Provider Business Mailing Address
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Address Line | 88 MAIN ST STE 302
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City | WATERVILLE
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State | ME
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Zip | 04901-6765
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Country | US
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Telephone | 862-432-9149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC18993
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC18993
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License Number State | ME
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