Provider Demographics
NPI:1336422930
Name:BORDEN, JANET GALE (LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:GALE
Last Name:BORDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:GALE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSCW
Mailing Address - Street 1:PO BOX 140903
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-0009
Mailing Address - Country:US
Mailing Address - Phone:918-697-4117
Mailing Address - Fax:918-488-8021
Practice Address - Street 1:2202 E 49TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-8714
Practice Address - Country:US
Practice Address - Phone:918-749-1840
Practice Address - Fax:918-451-9672
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK104100000X
OK50011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker