Litzy Jaqueline Bonilla

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

060144168 Issued in GA

Practice address

1664 Market Place Blvd
Cumming, GA 30041-7927

Phone

(470) 253-4121

NPI assigned

Feb 17, 2025

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1306641014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2547 LENOX DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305071712",
            "telephone_number": "770-540-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 MARKET PLACE BLVD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417927",
            "telephone_number": "470-253-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "LITZY",
        "middle_name": "JAQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "060144168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron B Bolds, MD, MBA
• Barbara E Boling, M.D.
• James Fred Boling, M.D.
• William Boling, M.D.
• Leanne Partridge Bolt, OTR/L
• William C Bonner, OD
• Gina Borgnini, O.D.
• Margaret Boudreaux, MD
• Heather Bousquet, LMSW
• Cara Bowen, LMSW

• Behavior Technician in Cumming, GA
• Providers in Cumming, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.