| Marisa Borgert, Psy.d., Llc | |
|
529 E Stroop Rd Dayton OH 45429-3245 | |
| (937) 294-6004 | |
| Not Available |
| Full Name | Marisa Borgert, Psy.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 529 E Stroop Rd, Dayton, Ohio |
| Authorized Official Name and Position | Marisa Christin Borgert (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9372946004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marisa Borgert, Psy.d., Llc 529 E Stroop Rd Dayton OH 45429-3245 Ph: (937) 294-6004 | Marisa Borgert, Psy.d., Llc 529 E Stroop Rd Dayton OH 45429-3245 Ph: (937) 294-6004 |
| NPI Number | 1780136267 |
|---|---|
| Provider Enumeration Date | 10/31/2016 |
| Last Update Date | 11/09/2016 |
| Medicare PECOS PAC ID | 0143501197 |
|---|---|
| Medicare Enrollment ID | O20170105000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780136267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Ohio) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6814 (Ohio) | Primary |
| Provider Name | Marisa C Borgert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790086494 PECOS PAC ID: 3173793106 Enrollment ID: I20110831000483 |
| Provider Name | Holly Andrea Sackett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619388360 PECOS PAC ID: 9032442918 Enrollment ID: I20190607001444 |
| Provider Name | Valerie L Budervic |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841761426 PECOS PAC ID: 6901130186 Enrollment ID: I20190621000049 |
| Provider Name | Devon Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366959751 PECOS PAC ID: 7315342565 Enrollment ID: I20210825004011 |
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