Provider Demographics
NPI:1083939730
Name:BORDWELL, ERIKA KAROLINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:KAROLINE
Last Name:BORDWELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:220 BROADWAY
Mailing Address - Street 2:TSP-NORTH AT FORT EDWARD UNION FREE SCHOOL
Mailing Address - City:FORT EDWARD
Mailing Address - State:NY
Mailing Address - Zip Code:12828-1520
Mailing Address - Country:US
Mailing Address - Phone:518-746-5815
Mailing Address - Fax:518-747-2034
Practice Address - Street 1:220 BROADWAY
Practice Address - Street 2:TSP-NORTH AT FORT EDWARD UNION FREE SCHOOL
Practice Address - City:FORT EDWARD
Practice Address - State:NY
Practice Address - Zip Code:12828-1520
Practice Address - Country:US
Practice Address - Phone:518-746-5815
Practice Address - Fax:518-747-2034
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016915103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical