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NPI Code Detail

MEDICARE: SUSAN ELLEN OSBORNE LCSW

MEDICARE: SUSAN ELLEN OSBORNE LCSW
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
11041C0700XClinical Social Worker1738KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437677333
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ELLEN OSBORNE LCSW
Provider Business Mailing Address
First Line : PO BOX 1080
Second Line :
City : BURKESVILLE
State : KY
Zip : 42717-1080
Country : US
Telephone Number : 270-858-6655
Fax Number : 270-858-4027
Provider Business Practice Location Address
First Line : 593 E MAIN ST
Second Line :
City : FRANKFORT
State : KY
Zip : 40601-2332
Country : US
Telephone Number : 502-223-0308
Fax Number : 502-227-5764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 08/31/2017

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Directions to “ SUSAN ELLEN OSBORNE LCSW” Practice Location

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