Diane Bosl, MS LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 2823 Issued in MN

Practice address

818 2ND St S
Suite 180
Waite Park, MN 56387-4528

Phone

(320) 257-1800

Fax

(320) 257-1801

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catholic Charities of the Diocese of St CloudGroup PAC ID 0648165928, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Catholic Charities of the Diocese of St. Cloud

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1780711341
  Medicare reassignment Care Compare group NPD
• Catholic Charities of the Diocese of St. Cloud

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1003944620
  NPD
• Granite City Counseling, LLC

  • Clinical Psychologist
  • Waite Park, MN
  • NPI 1699943209
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1689765232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 2ND STREET SOUTH",
            "address_2": "SUITE 180 GRANITE CITY COUNSELING, LLC",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "56387",
            "telephone_number": "320-257-1800",
            "fax_number": "320-257-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 2ND ST S",
            "address_2": "SUITE 180",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563874528",
            "telephone_number": "320-257-1800",
            "fax_number": "320-257-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSL",
        "first_name": "DIANE",
        "credential": "MS LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 2823",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "7148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "928250500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bjerke Counseling Services, LLC
• Jean M Bjerke, MA, LICSW
• Jordin Black
• Jaedon Wallace Boeve
• McKenzie Bomstad, MSW, LICSW
• Braaten Chiropractic LLC
• Jill M Braaten, DC
• Brittney Lee Braegelmann, DPT
• Margaret Braegelmann, PHARM.D.
• Carol Marguerite Brinkman, RN CNP

• Psychologist in Waite Park, MN
• Providers in Waite Park, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.