Provider Demographics
NPI:1588427181
Name:BORDENAVE, JANET B (LMFT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:B
Last Name:BORDENAVE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15624 QUAIL MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1748
Mailing Address - Country:US
Mailing Address - Phone:386-334-6739
Mailing Address - Fax:386-334-6739
Practice Address - Street 1:106 FOUR SEASONS SHOPPING CTR STE 103B
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3157
Practice Address - Country:US
Practice Address - Phone:386-334-6739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022031259106H00000X
FLMT3198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist