1881669323 NPI number — MARCIA BORING LCSW

Table of content: MARCIA BORING LCSW (NPI 1881669323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881669323 NPI number — MARCIA BORING LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BORING
Provider First Name:
MARCIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881669323
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7221 W 93RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZIONSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46077-9456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-873-2604
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9135 N. MERIDIAN ST.
Provider Second Line Business Practice Location Address:
SUITE A-6
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46260-1815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-727-2526
Provider Business Practice Location Address Fax Number:
317-581-1471
Provider Enumeration Date:
02/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  34000582A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)