MEDICARE: MS. STEPHANIE RENEE BORGMANN MSW, LCSW, RPT-S

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	1041C0700X	Clinical Social Worker	2010035432	MO

General Provider Information

NPI Number	:	1558666099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE RENEE BORGMANN MSW, LCSW, RPT-S

Provider Business Mailing Address
First Line	:	4531 WEBER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-5700
Country	:	US
Telephone Number	:	314-277-4154
Fax Number	:

Provider Business Practice Location Address
First Line	:	4529 WEBER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-5700
Country	:	US
Telephone Number	:	314-649-0083
Fax Number	:

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

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	12/14/2021

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