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

Sex

Female

Sole proprietor

Yes

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

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 12, 2019.

{
    "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": []
}

• Jeff Bertheola, DDS
• 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

• All providers in Fort Bragg, CA
• 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.