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NPI Code Detail

MEDICARE: BILLIE BORER BASW, LSW, LCDC-III

MEDICARE: BILLIE BORER BASW, LSW, LCDC-III
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
1101YA0400XAddiction (Substance Use Disorder) Counselor981085OH
2104100000XSocial WorkerS.0500256OH

General Provider Information

NPI Number : 1811357478
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILLIE BORER BASW, LSW, LCDC-III
Provider Business Mailing Address
First Line : 725 E MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44305-2421
Country : US
Telephone Number : 330-434-4141
Fax Number :
Provider Business Practice Location Address
First Line : 380 S PORTAGE PATH
Second Line :
City : AKRON
State : OH
Zip : 44320-2326
Country : US
Telephone Number : 330-315-4920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2016
Last Update Date : 02/25/2016

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