Individual
STACEY K. BORDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LADC-1
Contact information
Practice address
22 DRYDOCK AVE FL 3, BOSTON, MA 02210-2386
(857) 237-2780
(617) 507-6176
Mailing address
22 DRYDOCK AVE FL 3, BOSTON, MA 02210-2386
(857) 237-2780
(616) 507-6176
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14960
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81-1525549
MASSACHUSETTS INSURERS
MA
Enumeration date
04/20/2018
Last updated
04/20/2018
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