Provider Demographics
NPI:1013163864
Name:OSMONSON, JEFFREY D (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:D
Last Name:OSMONSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1296
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89803-1296
Mailing Address - Country:US
Mailing Address - Phone:775-777-9548
Mailing Address - Fax:775-753-5457
Practice Address - Street 1:174 IDAHO ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-3066
Practice Address - Country:US
Practice Address - Phone:775-777-9548
Practice Address - Fax:775-753-5457
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5189-C101YA0400X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health