Provider Demographics
NPI:1942431523
Name:BOORNAZIAN-MACDONALD, PATRICIA (LMFT, LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BOORNAZIAN-MACDONALD
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CARL RD
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1542
Mailing Address - Country:US
Mailing Address - Phone:508-822-5239
Mailing Address - Fax:
Practice Address - Street 1:5 WALPOLE ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3351
Practice Address - Country:US
Practice Address - Phone:781-278-9434
Practice Address - Fax:781-278-9434
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC -607101YM0800X
MALMFT-456106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist