Healthcare Provider Details
I. General information
NPI: 1780247122
Provider Name (Legal Business Name): CAITLIN BORGES LCSW-PIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/22/2019
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 E 69TH ST STE 205
SIOUX FALLS SD
57108-8322
US
IV. Provider business mailing address
1601 E 69TH ST STE 205
SIOUX FALLS SD
57108-8322
US
V. Phone/Fax
- Phone: 605-271-3575
- Fax:
- Phone: 605-271-3575
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 4862 |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 4862 |
| License Number State | SD |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: