Provider Demographics
NPI:1760188999
Name:BOROM, MARILYN S (LCSW-A)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:S
Last Name:BOROM
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723-0865
Mailing Address - Country:US
Mailing Address - Phone:828-399-1399
Mailing Address - Fax:828-475-0400
Practice Address - Street 1:3770 SKYLAND DR
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-8360
Practice Address - Country:US
Practice Address - Phone:828-399-1395
Practice Address - Fax:828-475-0400
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0190001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical