# MARK R BOROSKI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1841672821
- **Gender:** Man
- **Credential:** LMFT,LADC, MA,BS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1194 | CT | — |
| 106H00000X | Marriage & Family Therapist | 1951 | CT | Yes |

## Other

- **Enumeration date:** 06/25/2015
- **Last updated:** 03/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 008065074 | — | CT |
| 01 | — | 060669107 | HEALTHYCT WELLMORE GRP/FACILITY | CT |
| 01 | — | 10450310 402 E MAIN | BEACON HEALTH STRATEGIES | CT |
| 01 | — | 13823195 | CAQH | CT |
| 01 | — | CAC-6129 | CCB-CERTIFIED ADDICTION COUNSELOR | CT |
| 01 | — | ICADC-6129 | CCB- INTERNATIONALLY CERTIFIED ADDICTION COUNSELOR | CT |
| 01 | — | NOT ELIGIBLE | MHN TRICARENORTH | CT |
| 01 | — | PENDING | AETNA BEHAVIORAL HEALTH | CT |