DR. CHARLES MICHAEL BORDUIN (NPI# 1720178239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720178239 |
| Entity Type | Individual |
| Full Name | DR. CHARLES MICHAEL BORDUIN |
| Credential | PH.D. |
| Practice Address |
211 S. 8th Street Psychological Services Clinic University of Missouri Columbia MO 65211 |
| Practice Telephone | 5738824677 |
| Mailing Telephone | 5738824677 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
01144 | MO | Behavioral Health & Social Service Providers |
| Street Address |
211 S. 8TH STREET PSYCHOLOGICAL SERVICES CLINIC UNIVERSITY OF MISSOURI |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023510724 | Alison Mosel | Specialist/Technologist | University of Missouri - Columbia, 1 Champions Drive, Columbia, MO 65211 | 2018-03-08 |
| 1033629589 | Jessica Crane | Pharmacist | 911 E Rollins St., Room 1207 Mizzou Pharmacy, Columbia, MO 65211 | 2017-10-10 |
| 1760434096 | Deborah Marie Wright | Psychologist | Mu Assessment and Consultation Clinic, 205 Lewis Hall, Columbia, MO 65211 | 2006-05-16 |
| 1982185195 | Kyle Hamilton | Behavior Technician | 205 Portland St., Columbia, MO 65211 | 2018-08-25 |
| 1609051804 | Guy Louis Mccormack | Occupational Therapist | 300 Portland St, Suite 110 Thompson Center, Columbia, MO 65211 | 2008-01-07 |
| 1740894427 | Shraddha Niphadkar | Psychologist | 406 South 6th Street 119 Parker Hall, Columbia, MO 65211-0001 | 2020-09-01 |
| 1629638986 | Karl Osterman | Specialist/Technologist | 100 Missouri Athletics Training Complex Sports Medicine, Columbia, MO 65211-0001 | 2019-06-19 |
| 1588222541 | Nicholas Philpot | Specialist/Technologist | 213 Rothwell Gymnasium, Columbia, MO 65211-0001 | 2019-06-04 |
| 1740749340 | Greta Katherine Runge | Specialist/Technologist | 600 E Stadium, Columbia, MO 65211-0001 | 2019-03-14 |
| 1821557430 | Benjamin Kaullen Anthony | Specialist/Technologist | 600 E Stadium Blvd, Columbia, MO 65211-0001 | 2019-03-14 |
| Find all providers in zip 65211 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235577503 | Beth Anne Newman Feldman | Psychologist | 11912 Blue February Way, Columbia, MD 21044-4416 | 2013-06-10 |
| 1205989688 | Mary Ellen Degnan | Psychologist | 108 E Green Meadows Rd Ste 5, Columbia, MO 65203-3633 | 2007-01-19 |
| 1508913542 | Arnold Stanley Block | Psychologist | 5770 Sterrett Place, Suite 106, Columbia, MD 21044 | 2007-01-04 |
| 1932126760 | Mpb Group, Inc. | Psychologist | 9650 Santiago Rd Ste 11, Columbia, MD 21045-3960 | 2006-07-17 |
| 1053927004 | Kathryn L Marsh | Psychologist | 1505 Blanding St, Columbia, SC 29201-2906 | 2020-09-16 |
| 1235742552 | The Bridge Therapeutic & Evaluation Services, LLC | Psychologist | 7360 Grace Dr, Columbia, MD 21044-2470 | 2020-08-26 |
| 1194213355 | Rose Maura O'donnell | Psychologist | 205 Portland St, Columbia, MO 65201-6521 | 2018-04-24 |
| 1285163378 | Komila Brennan | Psychologist | 9810 Patuxent Woods Dr, Columbia, MD 21046-1595 | 2017-06-12 |
| 1790233666 | Kenneth M. Klebanow, M.d. & Associates, P.a. | Psychologist | 8821 Columbia 100 Pkwy, Columbia, MD 21045 | 2016-09-20 |
| 1639417157 | Emily Powell Lowell | Psychologist | 9 Richland Medical Park Dr Ste 210, Columbia, SC 29203-6859 | 2013-01-17 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.