Individual provider Active NPI

Kasey Lynn Osselborn, MS, LPC, NCC, CTRS

  • Mental Health Counselor
  • Saint Clairsville, OH
National Provider Identifier
1376194456
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2002537 Issued in OH
Practice address
67670 Traco Dr
Saint Clairsville, OH 43950-9375
Phone
(740) 695-2131
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 545 WV
Mental Health Counselor 101YM0800X 2002537 OH Primary

Addresses

Primary practice location

67670 Traco Dr
Saint Clairsville, OH 43950-9375

Mailing address

67670 Traco Dr
Saint Clairsville, OH 43950-9375
Phone (740) 695-2131

Other names 1

  • Kasey Lynn Hazi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240119000745 OH Practitioner - Mental Health Counselor 8729430335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coleman Professional Services, Inc.Group PAC ID 2769474618, 64 clinicians

Practice addresses (Care Compare)

400 Tuscarawas St W
Suite 200
Canton, OH 44702-2044
Phone (330) 438-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2002537OHMDMental Health Counselor
545WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Professional Services, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
BHC Fox Run Hospital Inc PastSince Jun 21, 2022 Accepting new patients

Locations

400 Tuscarawas St W
Ste 200
Canton, OH 44702
Phone (330) 438-1724

5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875

68150 Bayberry Dr
Saint Clairsville, OH 43950
Phone (740) 699-2300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1376194456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67670 TRACO DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439509375",
            "telephone_number": "740-695-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67670 TRACO DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439509375",
            "telephone_number": "740-695-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSELBORN",
        "first_name": "KASEY",
        "middle_name": "LYNN",
        "credential": "MS, LPC, NCC, CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WV",
            "license": "545",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "2002537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "HAZI",
            "middle_name": "LYNN",
            "credential": "CTRS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Clairsville, OH

Sources for this page

Verify at the official NPI Registry.