Provider Demographics
NPI:1275775975
Name:BORDEN PSYCHOLOGICAL SERVICES, P.A.
Entity Type:Organization
Organization Name:BORDEN PSYCHOLOGICAL SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-984-1404
Mailing Address - Street 1:1216 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1216 N CENTRAL EXPY
Practice Address - Street 2:SUITE 102
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3310
Practice Address - Country:US
Practice Address - Phone:972-984-1404
Practice Address - Fax:888-509-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty