Lauren M Bergamo

Individual provider Active NPI Behavior Technician · Albuquerque, NM

NPI 1104795608 · NPPES record last updated Nov 3, 2025

Key facts

NPI
1104795608
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4600 Columbine Ave NE
Albuquerque, NM 87113-2236
Phone
(505) 916-7618
NPI assigned
Nov 3, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NM Yes

Addresses

Primary practice location

4600 Columbine Ave NE
Albuquerque, NM 87113-2236

Mailing address

4600 Columbine Ave NE
Albuquerque, NM 87113-2236
Phone (505) 916-7618

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · Behavior Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.