Provider Demographics
NPI:1790186302
Name:OSBORN, KATLYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATLYNN
Middle Name:
Last Name:OSBORN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-9116
Mailing Address - Country:US
Mailing Address - Phone:904-605-4986
Mailing Address - Fax:941-460-5599
Practice Address - Street 1:230 E 22ND ST STE 4
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2661
Practice Address - Country:US
Practice Address - Phone:402-727-1592
Practice Address - Fax:402-727-4288
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10360101YM0800X
NE16391041C0700X
NE16971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health