Provider Demographics
NPI:1245838606
Name:BORDEN, CAROL (PHD, LPCC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16123 GRANT UTLEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:CASS LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56601
Mailing Address - Country:US
Mailing Address - Phone:218-335-3050
Mailing Address - Fax:218-335-4410
Practice Address - Street 1:16123 GRANT UTLEY AVE NW
Practice Address - Street 2:
Practice Address - City:CASS LAKE
Practice Address - State:MN
Practice Address - Zip Code:56601
Practice Address - Country:US
Practice Address - Phone:218-335-3050
Practice Address - Fax:218-335-4410
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MN1245838606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional