Provider Demographics
NPI:1639943897
Name:BORBELY, CARSON MARIE
Entity Type:Individual
Prefix:
First Name:CARSON
Middle Name:MARIE
Last Name:BORBELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5400
Mailing Address - Country:US
Mailing Address - Phone:608-233-2100
Mailing Address - Fax:608-233-2101
Practice Address - Street 1:5005 UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5400
Practice Address - Country:US
Practice Address - Phone:608-233-2100
Practice Address - Fax:608-233-2101
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1343851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical