Ivy Hazel Bermudez, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

77006 Issued in TX

Practice address

1145 Shasta Dr
Amarillo, TX 79110-3526

Phone

(806) 678-5652

NPI assigned

Jun 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Options for Southern Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grants Pass, OR
  • NPI 1558366492
  Medicare reassignment NPD
• Options for Southern Oregon

  • Primary Care Clinic/Center
  • Grants Pass, OR
  • NPI 1952708422
  NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1013533256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SHASTA DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791103526",
            "telephone_number": "806-678-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SHASTA DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791103526",
            "telephone_number": "806-678-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "IVY",
        "middle_name": "HAZEL",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "voltage",
            "affiliation": "N",
            "endpointDescription": "email system that encrypts emails",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email system",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted",
            "address_1": "1145 Shasta Dr",
            "city": "Amarillo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "791103526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley Bentley
• Howard Lysle Berg, MD
• Jessica Hanson Berg, M.P.A.S., P.A.-C
• Pamela L. Bergeron, RNC WHNP
• Renee Beth Bergmeier, R.D., L.D.
• Heath L Berna, RRT
• Carly Blair Berry, PT
• Deni Berry, FNP-C
• Joy Mignon Berry, O.D.
• Mike Preston Berry Jr., M.D.

• Professional Counselor in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.