Provider Demographics
NPI:1508587601
Name:DOUGLAS BORELL COUNSELING
Entity Type:Organization
Organization Name:DOUGLAS BORELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DOUGLAS-BORELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, LICDC
Authorized Official - Phone:419-787-2850
Mailing Address - Street 1:6450 WEATHERFIELD CT
Mailing Address - Street 2:STE 1B
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9149
Mailing Address - Country:US
Mailing Address - Phone:419-866-2830
Mailing Address - Fax:419-866-2831
Practice Address - Street 1:6450 WEATHERFIELD CT
Practice Address - Street 2:STE 1B
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9149
Practice Address - Country:US
Practice Address - Phone:419-866-2830
Practice Address - Fax:419-866-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty