JESSICA BASS BOSWORTH (NPI# 1154835577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154835577 |
| Entity Type | Individual |
| Full Name | JESSICA BASS BOSWORTH |
| Practice Address |
3415 Youngstown Dr Fayetteville NC 28303 |
| Mailing Address |
3415 Youngstown Dr Fayetteville NC 28303-4652 |
| Practice Telephone | 7034470454 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TS0200X |
Psychologist Specialization: School |
GA | Behavioral Health & Social Service Providers | |
| N | 103TS0200X |
Psychologist Specialization: School |
NC | Behavioral Health & Social Service Providers | |
| Y | 103TS0200X |
Psychologist Specialization: School |
VA | Behavioral Health & Social Service Providers |
| Street Address |
3415 YOUNGSTOWN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1639698871 | Audrey R Brown | Social Worker | 1003 Anarine Road, Fayetteville, NC 28303 | 2017-09-19 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467059824 | Logan Sheets | Psychologist | 370 N Drewrys Bluff Dr, Fayetteville, AR 72704-7103 | 2020-10-07 |
| 1629557053 | Brittany Noel Hall | Psychologist | 521 S Apple St, Fayetteville, OH 45118-8461 | 2018-08-07 |
| 1003004854 | Edward Lee Winter | Psychologist | 111 Fayette Ave., Fayette County Schools, Fayetteville, WV 25840 | 2007-10-05 |
| 1588292973 | Brittany Moore | Psychologist | 143 Skateway Dr, Fayetteville, NC 28304-2640 | 2020-03-31 |
| 1679907984 | Bryan Wilson | Psychologist | 111 Fayette Ave, Fayetteville, WV 25840-1219 | 2013-08-23 |
| 1023311933 | Neely Snead Harvey | Psychologist | 111 Fayette Ave, Fayetteville, WV 25840-1219 | 2010-12-15 |
| 1427226067 | David Gene Sweet | Psychologist | 111 Fayette Ave, Fayetteville, WV 25840-1219 | 2008-02-18 |
| 1457549206 | Bobbie Mae Mcclung | Psychologist | 111 Fayette Ave, Fayette County Schools, Fayetteville, WV 25840 | 2007-10-05 |
| 1427176023 | Robert Joseph Kohlbrenner | Psychologist | 6838 E Genesee St, Fayetteville, NY 13066-1029 | 2007-03-26 |
| 1447266531 | Sandra L. Smith | Psychologist | 7000 E Genesee St, Bldg.c, Fayetteville, NY 13066-1131 | 2006-07-31 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on JESSICA BASS BOSWORTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.