Lindsay Marcoullier Borda, O.T.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

0119003481 Issued in VA

Practice address

23378 Tradewind Dr
Brambleton, VA 20148-8091

Phone

(571) 216-7647

NPI assigned

May 3, 2007

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1962624361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23378 TRADEWIND DR",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201488091",
            "telephone_number": "571-216-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23378 TRADEWIND DR",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201488091",
            "telephone_number": "571-216-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDA",
        "first_name": "LINDSAY",
        "middle_name": "MARCOULLIER",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0119003481",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VA",
            "license": "0119003481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Brambleton, VA
• Providers in Brambleton, VA by specialty
• Pediatric Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.