Provider Demographics
NPI:1225476443
Name:BLOSS, JOANNA E (LMHC, LCPC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:E
Last Name:BLOSS
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1457
Mailing Address - Country:US
Mailing Address - Phone:317-743-8202
Mailing Address - Fax:317-743-8276
Practice Address - Street 1:435 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1457
Practice Address - Country:US
Practice Address - Phone:317-743-8202
Practice Address - Fax:317-743-8276
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009611101YP2500X
IN39003304A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional