Provider Demographics
NPI:1750652376
Name:BORGER, JEAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ELIZABETH
Last Name:BORGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-1533
Mailing Address - Country:US
Mailing Address - Phone:518-881-2000
Mailing Address - Fax:
Practice Address - Street 1:1880 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-1533
Practice Address - Country:US
Practice Address - Phone:518-881-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075760-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01406986Medicaid