Individual
MICHELLE BOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LCAC
Contact information
Practice address
316 LINCOLNWAY, LA PORTE, IN 46350
(219) 707-0178
(219) 325-0855
Mailing address
316 LINCOLNWAY, LA PORTE, IN 46350
(219) 707-0178
(219) 325-0855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000643A
IN
101YM0800X
Mental Health Counselor
Primary
39001957A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163580
—
IN
Enumeration date
04/23/2008
Last updated
09/17/2012
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