Provider Demographics
NPI:1275838898
Name:MICHAEL H. BORASH, LPC, P.C. & ASSOCIATES
Entity Type:Organization
Organization Name:MICHAEL H. BORASH, LPC, P.C. & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:BORASH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:703-492-8939
Mailing Address - Street 1:13885 HEDGEWOOD DR
Mailing Address - Street 2:STE 349
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-7928
Mailing Address - Country:US
Mailing Address - Phone:800-799-1212
Mailing Address - Fax:703-580-7840
Practice Address - Street 1:13885 HEDGEWOOD DR
Practice Address - Street 2:STE 349
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-7928
Practice Address - Country:US
Practice Address - Phone:800-799-1212
Practice Address - Fax:703-580-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000622101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty