Basic Information
| Provider Information | |||||||||
| NPI: | 1881169100 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BORDEN | ||||||||
| FirstName: | FAITH | ||||||||
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| Credential: | QP, MSW, LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3228 SHIRE LN APT B | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276063689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325704176 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 YONKERS RD | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276042258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198967536 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2018 | ||||||||
| LastUpdateDate: | 10/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | P012529 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.