MEDICARE: JESSICA L BOSECKER MHCA

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	101YM0800X	Mental Health Counselor	88000057A	IN

General Provider Information

NPI Number	:	1437513736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L BOSECKER MHCA

Provider Business Mailing Address
First Line	:	1513 25TH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-4387
Country	:	US
Telephone Number	:	812-302-2910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 25TH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-4387
Country	:	US
Telephone Number	:	812-302-2910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	06/12/2026

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