Individual provider · NPI-1

Larina Noelle Bongard, BS, RBT

Behavior Analyst · Lithonia, GA

NPI number1982204467

StatusActive

Last updated in NPPESSep 18, 2026

Details

NPI: 1982204467
Entity type: Individual (NPI-1)
Name: Larina Noelle Bongard
Credential: BS, RBT
Sex: Female
Sole proprietor: No
Enumeration date: Oct 26, 2020
Certification date: Sep 17, 2026
Last updated: Sep 18, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103K00000X	Behavior Analyst	–	GA	Yes
106S00000X	Behavior Technician	RBT-20-135627	GA

Practice location

5461 Hillandale Dr Ste 100
Lithonia, GA 30058-4842

Phone 470-361-2976

Mailing address

2008 Eastview Pkwy Ste 200, Conyers, Ga 30013
Conyers, GA 30013

Phone 648-905-1500

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