Mark R Boroski, LMFT,LADC, MA,BS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1951 Issued in CT

Practice address

400 Columbus Avenue
Adult Psychiatric Clinic
New Haven, CT 06519-1233

Phone

(203) 503-3075

Fax

(203) 503-3296

NPI assigned

Jun 25, 2015

Last updated

Mar 17, 2018By 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 2

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Master of Arts

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1841672821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7720",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065190720",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "ADULT PSYCHIATRIC CLINIC",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3075",
            "fax_number": "203-503-3296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 E Main St",
            "address_2": "Waterbury OP Adult Services",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021701",
            "country_code": "US",
            "telephone_number": "203-755-1143",
            "fax_number": "203-753-3274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOROSKI",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "LMFT,LADC, MA,BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1194",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT     WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "10450310 402 E MAIN",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN TRICARENORTH",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008065074",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM BEHAVIORAL HEALTH-UBH    WELLMORE FACILITY/GRP",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-CONNECTICARE   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-OXFORD FREEDOM/LIBERTY   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-UNITED HEALTHCARE  WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCB- INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR",
            "identifier": "ICADC-6129",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN MANAGED HEALTH NETWORK",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13823195",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCB-CERTIFIED ADDICTION COUNSELOR",
            "identifier": "CAC-6129",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Borak, MD
• Cara M Borelli
• Marissa Borgese, MD, MS
• Nathaniel I Borochov, MD
• Margaret Boron, MD
• Lauren Anne Borsavage
• Eric Max Bortnick, M.D.
• Satrajit Bose, M.D.
• Sophia Gabrielle Bosque
• Rebecca G Boswell, PHD

• Marriage & Family Therapist in New Haven, CT
• Providers in New Haven, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.