Provider Demographics
NPI:1831252931
Name:BADEN, RITA BORGS (LCSW)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:BORGS
Last Name:BADEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO B 682077
Mailing Address - Street 2:1745 SIDEWINDER AVE SUITE 200
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84068-2077
Mailing Address - Country:US
Mailing Address - Phone:435-659-9275
Mailing Address - Fax:435-655-3233
Practice Address - Street 1:1745 SIDEWINDER AVE
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84068-2077
Practice Address - Country:US
Practice Address - Phone:435-659-9275
Practice Address - Fax:435-655-3233
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12567435011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical