Provider Demographics
NPI:1568990661
Name:BORGWARDT, KRISTA (LICSW, LIMHP, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:BORGWARDT
Suffix:
Gender:F
Credentials:LICSW, LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 S 87TH ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3042
Mailing Address - Country:US
Mailing Address - Phone:1402-739-9820
Mailing Address - Fax:
Practice Address - Street 1:3031 S 87TH ST UNIT 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3042
Practice Address - Country:US
Practice Address - Phone:1402-739-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE71501041C0700X
NE11164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical