Individual provider Active NPI

Pamela A Bermender, LMFT

  • Marriage & Family Therapist
  • Cedar Park, TX
National Provider Identifier
1104179233
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201504 Issued in TX
Practice address
201 S Lakeline Blvd Ste 103
Cedar Park, TX 78613-2719
Phone
(512) 201-0741
Fax
(888) 971-3931
NPI assigned
Oct 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201504 TX Primary

Addresses

Primary practice location

201 S Lakeline Blvd Ste 103
Cedar Park, TX 78613-2719

Mailing address

3550 N Lakeline Blvd Ste 170-1515
Leander, TX 78641-3504
Phone (512) 201-0741

Other identifiers 1

IdentifierTypeStateIssuer
201504OtherTXMFT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240209000388 TX Practitioner - Marriage and Family Therapist 8628411386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4878 FM
Suite 3509
Burnet, TX 78611-5020
Phone (512) 201-0741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201504TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Engedi Life Care, PLLC CurrentSince Feb 12, 2024 Accepting new patients

Locations

201 S Lakeline Blvd
Ste 103
Cedar Park, TX 78613
Phone (512) 201-0741

1464 E Whitestone Blvd
Ste 202
Cedar Park, TX 78613
Phone (512) 528-5356

3550 N Lakeline Blvd
Ste 1701515
Leander, TX 78641

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1104179233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N LAKELINE BLVD STE 170-1515",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786413504",
            "telephone_number": "512-201-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LAKELINE BLVD STE 103",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132719",
            "telephone_number": "512-201-0741",
            "fax_number": "888-971-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMENDER",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICENSE",
            "identifier": "201504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.