Anna Victoria Bordelon, LCSW, DCSW

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

61934 Issued in TX

Practice address

886 Vaquero St
Allen, TX 75013-6138

Phone

(318) 759-5977

NPI assigned

Jul 10, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1144892191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 VAQUERO ST",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 VAQUERO ST",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136138",
            "telephone_number": "318-759-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "ANNA",
        "middle_name": "VICTORIA",
        "credential": "LCSW, DCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-10",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "61934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Bolden, MSW LCSW
• Robin Bolla Jr., OTR, OTD
• Mary Josephine Boney
• Shauntelle Dene Bonman, D.O.
• Natasha Bonner, D.C.
• Alisia Marie Borja
• Rebecca Paradis Bork, D.D.S.
• Jennifer Michelle Boswell, FNP
• Carly Bouche
• Boundless Possibilities, Inc.

• Athletic Trainer in Allen, TX
• Providers in Allen, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.