Borrelli PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BORRELLI PC

Practice address

530 Causeway Dr Ste A2
Wrightsville Beach, NC 28480-1959

Phone

(910) 408-2302

Fax

(833) 211-4849

NPI assigned

Apr 28, 2020

Organization subpart

No

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

Authorized official

Name

Stefanie Roback, LCSW, LCASNPI 1629421698

Title

President

Phone

(910) 408-2302

Specialties & licenses 2

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stefanie Lynn Roback, MSW, LCSW, LCAS

  • Clinical Social Worker
  • Wrightsville Beach, NC
  • NPI 1629421698
  NPD Authorized official
• Taylor Manfredi, MSW, LCSW

  • Clinical Social Worker
  • Wrightsville Beach, NC
  • NPI 1922651116
  NPD
• Monica Marie Flores de Valgaz, LCMHCA

  • Mental Health Counselor
  • Wilmington, NC
  • NPI 1447997572
  NPD (past)

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1174144471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CAUSEWAY DR STE A2",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801959",
            "telephone_number": "910-408-2302",
            "fax_number": "833-211-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CAUSEWAY DR STE A2",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801959",
            "telephone_number": "910-408-2302",
            "fax_number": "833-211-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORRELLI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "ROBACK",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-408-2302",
        "authorized_official_credential": "LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• At Home Therapy of Wilmington, Inc.
• Allan Leslie Meyer Barker, O.D.
• Laura L Barnes, P.T.
• Emily Joann Beddoes, M.S.
• Seth Berkebile, OTRL
• Norman J Brooks, PTA
• Harry Dwight Cowart, PHARMD
• Edith Margaret D'Aquila-Lloyd, FNP
• Ashley Cook Degroote, MS CCC-SLP
• Madilyn Grace Dombrowski

• Clinical Social Worker in Wrightsville Beach, NC
• Providers in Wrightsville Beach, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.