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NPI 1891575171

NPI 1891575171 : BORKOR PSYCHOTHERAPY SERVICES LCSW, PLLC : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1891575171
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    Entity Type          |    Organization 
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    Legal Business Name  |    BORKOR PSYCHOTHERAPY SERVICES LCSW, PLLC 
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Dates
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    Enumeration Date     |    10/03/2023
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    Last Update Date     |    10/03/2023
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Provider Practice Location Address
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    Address Line         |    335 FENIMORE ST APT 2B 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11225-6154
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    Country              |    US
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    Telephone            |    917-805-8275
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    Fax                  |    917-634-8776
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Provider Business Mailing Address
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    Address Line         |    335 FENIMORE ST APT 2B 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11225-6154
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    Country              |    US
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    Telephone            |    917-805-8275
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    Fax                  |    917-634-8776
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Authorized Official
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    Title or Position    |    CEO/CLINICAL DIRECTOR
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    Name                 |     PRISCILLA T BORKOR 
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    Credential           |    LCSW
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    Telephone            |    917-805-8275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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