Provider Demographics
NPI:1073842548
Name:BOSCHEN, JON E (LCSW, LCADC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:E
Last Name:BOSCHEN
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 MAIN ST
Mailing Address - Street 2:STE 110
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1910
Mailing Address - Country:US
Mailing Address - Phone:862-432-9149
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:STE 110
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1910
Practice Address - Country:US
Practice Address - Phone:862-432-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-13
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00179100101YA0400X
NJ44SC05559800101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health