Bordman, Kelly

Bordman, Kelly is an sole proprietor health care provider with primary practice located at 200 Michigan Ave , Vista CA 92084-5424. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Bordman, Kelly can be contacted via phone (760) 726-4900.

Contact Information

Primary practice address
200 Michigan Ave Vista CA 92084-5424
Phone: (760) 726-4900
Fax: (760) 631-5633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 69179 California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1184753980
LBN Legal business name Bordman, Kelly
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2007
Last updated Feb 22nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184753980 NPPES
California Other 23635 ASW INTERN REGISTRATION #

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