Individual provider Active NPI

Debora Bortnik, LMHC

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1508263492
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12969 Issued in FL
Practice address
9075 SW 87TH Ave
Suite 412
Miami, FL 33176-2308
Phone
(305) 815-2787
NPI assigned
Nov 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH12969 FL Primary

Addresses

Primary practice location

9075 SW 87TH Ave
Suite 412
Miami, FL 33176-2308

Mailing address

12850 SW 71St Ave
Miami, FL 33156-6273
Phone (305) 297-1472

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
MH12969FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1508263492",
    "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",
            "telephone_number": "305-297-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 SW 87TH AVE",
            "address_2": "SUITE 412",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762308",
            "telephone_number": "305-815-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTNIK",
        "first_name": "DEBORA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12969",
            "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 Nov 20, 2014; 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.