Individual provider Active NPI

Michelle Bortnik, LMFT

  • Community/Behavioral Health Agency
  • Miami, FL
National Provider Identifier
1316362254
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MT3021 Issued in FL
Practice address
1380 NE Miami Gardens Dr Ste 255
Miami, FL 33179-4721
Phone
(305) 815-2174
NPI assigned
Mar 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MT3021 FL Primary

Addresses

Primary practice location

1380 NE Miami Gardens Dr Ste 255
Miami, FL 33179-4721

Mailing address

12850 SW 71St Ave
Miami, FL 33156-6273

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT3021FLMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1393718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1316362254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 SW 71ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331566273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 NE MIAMI GARDENS DR STE 255",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331794721",
            "telephone_number": "305-815-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTNIK",
        "first_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-02",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MT3021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.