Provider Demographics
NPI:1629630942
Name:HOSIER, KENNETH (LMHC)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:HOSIER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 HOBSON CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-8648
Mailing Address - Country:US
Mailing Address - Phone:260-486-5251
Mailing Address - Fax:260-486-5058
Practice Address - Street 1:4214 HOBSON CT
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-8648
Practice Address - Country:US
Practice Address - Phone:260-486-5251
Practice Address - Fax:260-486-5058
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003559A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1962432971OtherGROUP NPI