Julie A Borgen, LCSW

Individual provider Active NPI Clinical Social Worker · Canandaigua, NY

NPI 1639488307 · NPPES record last updated Apr 25, 2011

Key facts

NPI
1639488307
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R040491-1 (NY)
Practice address
400 Fort Hill Ave
Canandaigua, NY 14424-1159
Phone
(585) 393-7777
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R040491-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R040491-1 NY Yes

Addresses

Primary practice location

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Mailing address

688 East Ave
Apt 2a
Rochester, NY 14607-2155
Phone (585) 473-3508

Other providers in Canandaigua, NY

All providers in Canandaigua, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.