Christopher Bordelon, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019219 Issued in NC

Practice address

6115 Park South Dr Ste 135
Charlotte, NC 28210-3269

Phone

(704) 285-0241

NPI assigned

Jun 30, 2023

Last updated

Jun 30, 2023By the provider in NPPES

Sex

Male

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 NC

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

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Achieve Balance, PLLC

  • Marriage & Family Therapist
  • Charlotte, NC
  • NPI 1265934731
  Medicare reassignment
• QC Wellness Collective, PLLC

  dba Ellie Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charlotte, NC
  • NPI 1942905575
  NPD

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1467139501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 PHILEMON AVE APT 1445",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282062314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 135",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103269",
            "telephone_number": "704-285-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "CHRISTOPHER",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Dedmond Boothe, RN, PA-C
• Skyler Jo Booths, PHARMD
• Shannon Elizabeth Boraski
• Catherine Jones Bordeaux, P.A.
• Morgan Jean Bordeaux
• Teresa Bordelon, CRNA
• Jennifer Boren
• Nyal Borges, MD
• Vivien Haupt Borghi, NP
• Nelly Borisov

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, 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 Jun 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.