Individual
MR. BRUCE WILLARD OSBORNE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1800 ZHALE SMITH ROAD, LA GRANGE, KY 40031
(502) 264-1514
(502) 371-7550
Mailing address
P O BOX 514, LA GRANGE, KY 40031
(502) 264-1514
(502) 371-7550
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
KY-1524
KY
101YP2500X
Professional Counselor
LPC0000000736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11539066
CAQH
TN
01
—
230204
OPTUM EAP
TN
01
—
283910000
MAGELLAN
TN
01
—
4058210
BLUE CROSS BLUE SHIELD
TN
05
—
5441054
—
TN
Enumeration date
05/15/2006
Last updated
06/04/2014
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