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NPI Code Detail

MEDICARE: BRAXTON BOSSHART CSW

MEDICARE: BRAXTON BOSSHART CSW
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 Worker260461KY

General Provider Information

NPI Number : 1558228569
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAXTON BOSSHART CSW
Provider Business Mailing Address
First Line : 410 CHRISMAN OAKS TRL
Second Line :
City : NICHOLASVILLE
State : KY
Zip : 40356-7016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2250 THUNDERSTICK DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40505-9010
Country : US
Telephone Number : 859-254-1035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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Directions to “ BRAXTON BOSSHART CSW” Practice Location

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