Provider Demographics
NPI:1124995550
Name:BORDELON, MARCELLE M (LPC)
Entity type:Individual
Prefix:
First Name:MARCELLE
Middle Name:M
Last Name:BORDELON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 ENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-3656
Mailing Address - Country:US
Mailing Address - Phone:518-557-9934
Mailing Address - Fax:
Practice Address - Street 1:343 ENFIELD DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-3656
Practice Address - Country:US
Practice Address - Phone:518-557-9934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional