Erika Karoline Bordwell, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016915 Issued in NY

Practice address

220 Broadway
TSP-North at Fort Edward Union Free School
Fort Edward, NY 12828-1520

Phone

(518) 746-5815

Fax

(518) 747-2034

NPI assigned

Apr 6, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1083939730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BROADWAY",
            "address_2": "TSP-NORTH AT FORT EDWARD UNION FREE SCHOOL",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281520",
            "telephone_number": "518-746-5815",
            "fax_number": "518-747-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BROADWAY",
            "address_2": "TSP-NORTH AT FORT EDWARD UNION FREE SCHOOL",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281520",
            "telephone_number": "518-746-5815",
            "fax_number": "518-747-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDWELL",
        "first_name": "ERIKA",
        "middle_name": "KAROLINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Lynne Blackmer, FNP
• Dakota Storm Blake, PTA
• Theresa Blanchard
• Theresa Anne Boire, OTR/L
• Marinea Bonenfant
• Jessi Boucher, LCSW
• Jamie D Bovair, ANP
• Maria Lynne Brayton, LMHC
• Jacalyn Brennan, MS/SLP/CCC
• Catherine Margaret Briscoe

• All providers in Fort Edward, NY
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.