Individual
COREY BOREN
Active
Individual
COREY BOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
458632154989544
AR
101YM0800X
Mental Health Counselor
8469754655565
OK
103TC0700X
Clinical Psychologist
11564758-4805
UT
103TC0700X
Clinical Psychologist
Primary
4521033015
MO
103TC0700X
Clinical Psychologist
74125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25746
PHYPACT
CA
05
—
458632154989544
—
AR
Enumeration date
08/02/2022
Last updated
07/20/2026
Update your record
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