Healthcare Provider Details

I. General information

NPI: 1528847373
Provider Name (Legal Business Name): ANNA BOROWYJ MA LPCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST STE Q3
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

111 APACHE RIDGE RD
SANTA FE NM
87505-1467
US

V. Phone/Fax

Practice location:
  • Phone: 505-629-5510
  • Fax:
Mailing address:
  • Phone: 505-629-5510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNA SUDHIR BOROWYJ
Title or Position: COUNSELOR
Credential: LPCC
Phone: 505-629-5510