Provider Demographics
NPI:1952970337
Name:JOSH BORRELLI, PSY.D., LLC
Entity Type:Organization
Organization Name:JOSH BORRELLI, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:BORRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:503-550-3677
Mailing Address - Street 1:18235 SW 135TH TER
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7321
Mailing Address - Country:US
Mailing Address - Phone:503-550-3677
Mailing Address - Fax:503-213-6378
Practice Address - Street 1:18235 SW 135TH TER
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7321
Practice Address - Country:US
Practice Address - Phone:503-550-3677
Practice Address - Fax:503-213-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health