Active NPI
Matthew Borer, PH.D. LMFT
- Marriage & Family Therapist
- Jacksonville, FL
National Provider Identifier
1982980603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT 2536
- Practice address
- 2720 Park St
209
Jacksonville, FL 32205-7644 - Phone
- (904) 874-1387
- NPI assigned
- Oct 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT 2536 | FL | Primary |
Addresses
Primary practice location
2720 Park St
209
Jacksonville, FL 32205-7644
Mailing address
2720 Park St
209
Jacksonville, FL 32205-7644
Phone (904) 874-1387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT 2536 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319587200000",
"number": "1982980603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 PARK ST",
"address_2": "209",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322057644",
"telephone_number": "904-874-1387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 PARK ST",
"address_2": "209",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322057644",
"telephone_number": "904-874-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORER",
"first_name": "MATTHEW",
"credential": "PH.D. LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-26",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.