Healthcare Provider Details

I. General information

NPI: 1962113225
Provider Name (Legal Business Name): TRISHA ELENA BORDAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E COMMERCIAL BLVD STE 101
FORT LAUDERDALE FL
33308-4022
US

IV. Provider business mailing address

2400 E COMMERCIAL BLVD STE 101
FORT LAUDERDALE FL
33308-4022
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 833-769-3524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24203
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: