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NPI Code Detail

MEDICARE: JANET BORDEN, LCSW, PLLC

MEDICARE: JANET BORDEN, LCSW, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker5001OK

General Provider Information

NPI Number : 1750764072
Entity Type Code : Organization
Provider Name (Legal Business Name) : JANET BORDEN, LCSW, PLLC
Provider Business Mailing Address
First Line : PO BOX 140903
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74014-0009
Country : US
Telephone Number : 918-697-4117
Fax Number :
Provider Business Practice Location Address
First Line : 2202 E 49TH ST STE 400
Second Line :
City : TULSA
State : OK
Zip : 74105-8714
Country : US
Telephone Number : 918-749-1840
Fax Number : 918-451-9672
Authorized Official
Title or Position : MANAGER
Name : JANET BORDEN
Credential : LCSW
Telephone Number : 918-697-4117
Provider Enumeration Date : 07/06/2015
Last Update Date : 06/08/2021

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