Ashlyn Brooke Bordelon, M. ED, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8397 Issued in SC

Practice address

455 Saint Andrews Rd Ste D1
Columbia, SC 29210-4488

Phone

(803) 638-4688

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 7, 2025 through May 7, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1164034294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SAINT ANDREWS RD STE D1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104488",
            "telephone_number": "803-638-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SAINT ANDREWS RD STE D1",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104488",
            "telephone_number": "803-638-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "ASHLYN",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "M. ED, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7476",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "8397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayce Booth
• Lauren Booth
• Taryn R. Booth, PH.D, LPC, CRC, NCC
• Caison Felts Boozer, MSP, CCC-SLP
• Vicki McConkey Boozer, RPH
• Valincia Borders
• Kristina Borglum
• Ky Allen Borgstadt, D.C.
• Isha Borhara
• Christi Celinda Borrell-Moreno, LCSW

• Mental Health Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.