Active NPI
Larina Noelle Bongard, BS, RBT
- Behavior Technician
- Lithonia, GA
National Provider Identifier
1982204467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-135627
- Practice address
- 5461 Hillandale Dr Ste 100
Lithonia, GA 30058-4842 - Phone
- (470) 361-2976
- NPI assigned
- Oct 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-135627 | GA | Primary |
Addresses
Primary practice location
5461 Hillandale Dr Ste 100
Lithonia, GA 30058-4842
Mailing address
5461 Hillandale Dr Ste 100
Lithonia, GA 30058-4842
Phone (470) 361-2976
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-135627 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1982204467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5461 HILLANDALE DR STE 100",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300584842",
"telephone_number": "470-361-2976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5461 HILLANDALE DR STE 100",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300584842",
"telephone_number": "470-361-2976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGARD",
"first_name": "LARINA",
"middle_name": "NOELLE",
"credential": "BS, RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2023-07-24",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-20-135627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.