Barbara Bornstein, PH.D.
Individual provider Active NPI Psychologist · Bayside, WI
NPI 1275914129 · NPPES record last updated Jun 17, 2015
Key facts
- NPI
- 1275914129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 1680-57 (WI)
- Practice address
- 8989 N Port Washington Rd
Suite 220
Bayside, WI 53217-1671 - Phone
- (414) 813-8989
- NPI assigned
- Jun 17, 2015
- 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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1680-057 | WI | MD | Family Psychologist |
| 1680-57 | WI | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bornstein Psychological Services LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1680-57 | WI | Yes |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1680-057 | WI | |
| Family Psychologist | 103TF0000X | 1680-057 | WI | |
| School Psychologist | 103TS0200X | 1680-57 | WI |
Addresses
Primary practice location
8989 N Port Washington Rd
Suite 220
Bayside, WI 53217-1671
Mailing address
12319 N Golf Dr
Mequon, WI 53092-2461
Phone (414) 813-8989
Other providers in Bayside, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2015. 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.