Provider Demographics
NPI:1235904194
Name:OSGOOD, JONATHAN F (PLPC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:F
Last Name:OSGOOD
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8702 W 49TH TERR
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66203-1712
Mailing Address - Country:US
Mailing Address - Phone:913-263-6006
Mailing Address - Fax:816-836-2923
Practice Address - Street 1:801 NE ANDERSON LN
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064
Practice Address - Country:US
Practice Address - Phone:913-263-6006
Practice Address - Fax:818-836-2923
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230420251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical