Provider Demographics
NPI:1467864249
Name:BOSSE, KATHLEEN E (BS, MA, LPC-CR)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:BOSSE
Suffix:
Gender:F
Credentials:BS, MA, LPC-CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7332 HOSBROOK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-1712
Mailing Address - Country:US
Mailing Address - Phone:513-374-0177
Mailing Address - Fax:
Practice Address - Street 1:1251 NILLES RD
Practice Address - Street 2:UNIT 5
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7206
Practice Address - Country:US
Practice Address - Phone:513-939-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1200581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health