Sommer Bergdale, M.A.
Individual provider Active NPI Counselor · Las Vegas, NV
NPI 1013243591 · NPPES record last updated Oct 19, 2009
Key facts
- NPI
- 1013243591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 578 Redruth Dr
Las Vegas, NV 89178-1282 - Phone
- (702) 376-0024
- NPI assigned
- Oct 19, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bergdale and Hall LLC
Practice addresses (Care Compare)
6885 W Charleston Blvd
Las Vegas, NV 89117-1600
Phone (702) 608-4220
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240410001358 | NV | Practitioner - Mental Health Counselor | 6507167517 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bergdale & Hall, LLC | Current |
Accepting new patients | |
| Bergdale & Hall, LLC | Current |
Accepting new patients | |
| Serenity Counseling and Support Services | Past | Accepting new patients |
Locations
6879 W Charleston Blvd
Ste A
Las Vegas, NV 89117
Phone (702) 308-4807
6885 W Charleston Blvd
Las Vegas, NV 89117
Phone (702) 483-7367
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
578 Redruth Dr
Las Vegas, NV 89178-1282
Mailing address
578 Redruth Dr
Las Vegas, NV 89178-1282
Phone (702) 376-0024
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.