Provider Demographics
NPI:1295145795
Name:BORLAND, MARK A (LPC, PHD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:BORLAND
Suffix:
Gender:M
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-5024
Mailing Address - Country:US
Mailing Address - Phone:814-397-6272
Mailing Address - Fax:814-836-8194
Practice Address - Street 1:1738 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-5024
Practice Address - Country:US
Practice Address - Phone:814-722-7467
Practice Address - Fax:814-836-8194
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health