Lauren Beth Bortnem, M.ED., BCBA
Individual provider Active NPI Behavior Analyst · Magnolia, TX
NPI 1033459367 · NPPES record last updated Mar 29, 2017
Key facts
- NPI
- 1033459367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-10-7001 (TX)
- Practice address
- 23511 Sonoma Valley Dr
Magnolia, TX 77355-2038 - Phone
- (281) 804-2257
- NPI assigned
- Feb 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Jeremiah Center, LLC | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-10-7001 | TX | Yes |
Addresses
Primary practice location
23511 Sonoma Valley Dr
Magnolia, TX 77355-2038
Mailing address
23511 Sonoma Valley Dr
Magnolia, TX 77355-2038
Phone (281) 804-2257
Other providers in Magnolia, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.