Provider Demographics
NPI:1073842548
Name:BOSCHEN, JON E (LCSW, LCADC)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:E
Last Name:BOSCHEN
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 MAIN ST
Mailing Address - Street 2:STE 110
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1910
Mailing Address - Country:US
Mailing Address - Phone:862-432-9149
Mailing Address - Fax:
Practice Address - Street 1:210 MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-4362
Practice Address - Country:US
Practice Address - Phone:862-432-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-13
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00179100101YA0400X
NJ44SC055598001041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical