NPIMap

Organization Active NPI

Marisa Borgert, Psy.D., LLC

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1780136267
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6814 Issued in OH
Legal business name
MARISA BORGERT, PSY.D., LLC
Practice address
8063 Washington Village Dr
Dayton, OH 45458-1847
Phone
(937) 294-6004
NPI assigned
Oct 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Dr. Marisa Christin Borgert, PSY.D.NPI 1790086494
Title
Clinical Psychologist/Owner
Phone
(937) 294-6004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X OH
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6814 OH Primary

Addresses

Primary practice location

8063 Washington Village Dr
Dayton, OH 45458-1847

Mailing address

8063 Washington Village Dr
Dayton, OH 45458-1847
Phone (937) 294-6004

Other names 1

  • Empower psychology and wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170105000745 OH Part B Supplier - Clinic/Group Practice 0143501197 Receives reassigned benefits from 6 practitioners
Practice locations: Beavercreek, OH; Dayton, OH

National Provider Directory

National Provider Directory

Locations

2601 Commons Blvd
Ste 110
Beavercreek, OH 45431
Phone (937) 294-6004

8063 Washington Village Dr
Dayton, OH 45458
Phone (937) 294-6004

537 E Stroop Rd
Kettering, OH 45429
Phone (937) 294-6004

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1780136267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8063 WASHINGTON VILLAGE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581847",
            "telephone_number": "937-294-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8063 WASHINGTON VILLAGE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581847",
            "telephone_number": "937-294-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISA BORGERT, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-31",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "BORGERT",
        "authorized_official_first_name": "MARISA",
        "authorized_official_middle_name": "CHRISTIN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "937-294-6004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Empower psychology and wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.