Chrissy M Bosley, LCSW QCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1200719 Issued in OH

Practice address

11147 State Hwy 18 Suite #5
Suite #5
Conneaut Lake, PA 16316

Phone

(814) 382-8798

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA

  Medicare reassignment
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1295829273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11147 STATE HWY 18 SUITE #5",
            "address_2": "SUITE #5",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "16316",
            "telephone_number": "814-382-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11147 STATE HWY 18 SUITE #5",
            "address_2": "SUITE #5",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "16316",
            "telephone_number": "814-382-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "CHRISSY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW QCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW013913",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW4530",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1200719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Nicole Bielata, MA, NCC
• Nour Majid Bussard, LPC
• Casey James Chapman, DC
• Kimberly Marie Conley, LCSW
• Conneaut Lake Area Ambulance Service
• Conneaut Lake Chiropractic, PC

• Clinical Social Worker in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.