Provider Demographics
NPI:1609469410
Name:BORATYN, FELIX (LMSW)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:BORATYN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:FELIX
Other - Middle Name:
Other - Last Name:BORATYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:9409 N HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4696
Mailing Address - Country:US
Mailing Address - Phone:224-202-6124
Mailing Address - Fax:
Practice Address - Street 1:9409 N HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4696
Practice Address - Country:US
Practice Address - Phone:224-202-6124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011168381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical