Provider Demographics
NPI:1437394962
Name:BOROW-BERDON, RANDI (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:
Last Name:BOROW-BERDON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 W PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2018
Mailing Address - Country:US
Mailing Address - Phone:914-668-9124
Mailing Address - Fax:914-668-0940
Practice Address - Street 1:9 WEST PROSPECT AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:MT. VERNON
Practice Address - State:NY
Practice Address - Zip Code:10530
Practice Address - Country:US
Practice Address - Phone:914-668-9124
Practice Address - Fax:914-668-0940
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0775981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY131773419OtherFAMILY SERVICES OF WESTCHESTER