MEDICARE: JOSEPH J BOROSKI LPCC

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
1	101YP2500X	Professional Counselor	E0003917	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000217375	OTHER	KY	ANTHEM BCBS

General Provider Information

NPI Number	:	1386784866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH J BOROSKI LPCC

Provider Business Mailing Address
First Line	:	68353 BANNOCK RD
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-9736
Country	:	US
Telephone Number	:	740-695-9344
Fax Number	:	740-695-7787

Provider Business Practice Location Address
First Line	:	68353 BANNOCK RD
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-9736
Country	:	US
Telephone Number	:	740-695-9344
Fax Number	:	740-695-7787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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