Terry Bordan, ED.D., LMHC, CCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

000076 Issued in NY

Practice address

128 Village GRN
Port Washington, NY 11050-4712

Phone

(516) 883-1487

Fax

(516) 467-4649

NPI assigned

May 15, 2007

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

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902012313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 VILLAGE GRN",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504712",
            "telephone_number": "516-883-1487",
            "fax_number": "516-467-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 VILLAGE GRN",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504712",
            "telephone_number": "516-883-1487",
            "fax_number": "516-467-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDAN",
        "first_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "ED.D., LMHC, CCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Bloom, COTA
• Fred Blum I, D.C.
• Ingrid Maria Blumenkrantz, M.D.
• Joel Blush, M.D.
• Valerie Bongiovi, NPP
• Allegra Borghese, PHD
• Julia Boroday
• Brad Levine DMD PC
• Nancy Schaeffer Braman, PH.D.
• Hal Brickman, HAL BRICKMAN

• Mental Health Counselor in Port Washington, NY
• Providers in Port Washington, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.