Lynne Barbara Bornheim, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS14229 Issued in CA

Practice address

205 South St
Fort Bragg, CA 95437

Phone

(707) 961-4088

NPI assigned

Nov 21, 2009

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lynnebornheim@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1073841540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST STE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-961-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 34th St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092815",
            "country_code": "US",
            "telephone_number": "510-469-8714",
            "fax_number": "510-597-0104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "465 34th St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092815",
            "country_code": "US",
            "telephone_number": "510-469-8714",
            "fax_number": "510-597-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORNHEIM",
        "first_name": "LYNNE",
        "middle_name": "BARBARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-21",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Josephine Bever
• Janet Lynn Biasca, RPH
• Bitterroot Family Therapy Inc.
• Rena Blauner, LCSW
• Colleen Boggs, DENTIAL HYGIENIST
• Brandon Lebeck Dental Corp
• Jenna Rose Breton, NPF
• Rebecca Britton
• Jennifer Kay Brown, PA
• Michael E. Brown, MD

• Clinical Social Worker in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.