Provider Demographics
NPI:1598107450
Name:BOORSE, JEFFREY JOSEPH (MS, LPC, CCDPD, CHT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JOSEPH
Last Name:BOORSE
Suffix:
Gender:M
Credentials:MS, LPC, CCDPD, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-5568
Mailing Address - Country:US
Mailing Address - Phone:267-934-7052
Mailing Address - Fax:
Practice Address - Street 1:1234 BRIDGETOWN PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-2208
Practice Address - Country:US
Practice Address - Phone:267-934-7052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-20
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional