Laura Bordjadze

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.1902313 Issued in OH

Practice address

1565 Bethel Rd
Columbus, OH 43220-2005

Phone

(614) 459-3003

Fax

(614) 459-3004

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1861065880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202005",
            "telephone_number": "614-459-3003",
            "fax_number": "614-459-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202005",
            "telephone_number": "614-459-3003",
            "fax_number": "614-459-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDJADZE",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1902313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURER AGREEMENTS",
            "identifier": "C.1902313",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "614-459-3004",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1565 Bethel Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432202005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey Tyler Bord, MS, ATC, CSCS
• David Bordeaux
• Ashley Fox Borden
• Jonathan O'Neal Borders, M.D.
• Michael Terry Borders
• Cole Martin Bordner, MD
• Joshua Todd Bordner, CNP
• Patricia Carol Bordner, NP-C
• Joann Borer, LSW
• Jesse R Borgelt, CRNA

• Mental Health Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.