Provider Demographics
NPI:1871925966
Name:OSBORN, JESSE MICHAEL (MSW)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:MICHAEL
Last Name:OSBORN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINDA AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1313
Mailing Address - Country:US
Mailing Address - Phone:914-773-7500
Mailing Address - Fax:
Practice Address - Street 1:500 LINDA AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1313
Practice Address - Country:US
Practice Address - Phone:914-773-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health