MEDICARE: OSBORNE MENTAL WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1235890120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSBORNE MENTAL WELLNESS

Provider Business Mailing Address
First Line	:	215 VETERANS DR
Second Line	:
City	:	NOTTINGHAM
State	:	PA
Zip	:	19362-9156
Country	:	US
Telephone Number	:	610-731-4307
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 RYAN DR
Second Line	:
City	:	RISING SUN
State	:	MD
Zip	:	21911-1840
Country	:	US
Telephone Number	:	610-731-4307
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAREN OSBORNE
Credential	:	PMHNP-BC
Telephone Number	:	610-731-4307

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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Directions to “OSBORNE MENTAL WELLNESS ” Practice Location

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