Laurell Bertino, LPCC
Individual provider Active NPI Professional Counselor · Las Vegas, NV
NPI 1306201751 · NPPES record last updated Mar 17, 2026
Key facts
- NPI
- 1306201751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5785 (CA)
- Practice address
- 27 E Agate Ave Unit 303
Las Vegas, NV 89123-6069 - Phone
- (209) 584-4122
- NPI assigned
- Dec 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sud Specialty Group - Ca
Practice addresses (Care Compare)
4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20251125002760 | CA | Practitioner - Mental Health Counselor | 2466944582 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5785 | CA | MD | Professional Counselor |
| CP6032-R | NV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sud Specialty Group - Ca | Multi-Specialty | Current |
Accepting new patients |
Locations
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428
520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | CP6032-R | NV | |
| Prison Health Clinic/Center | 261QP2400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Art Therapist | 221700000X | CA | ||
| Professional Counselor |
101YP2500X | 5785 | CA | Yes |
Addresses
Primary practice location
27 E Agate Ave Unit 303
Las Vegas, NV 89123-6069
Mailing address
27 E Agate Ave Unit 303
Las Vegas, NV 89123-6069
Phone (209) 584-4122
Other providers in Las Vegas, NV
- Zkmain Barnadette Bertaud
- Hannah Bertel
- Jessica Bertemati
- Kyleesha Bertha
- Dean P Berthoty
- Darlene Bertling
- Mary Jane Bertram
- Christina Nicole Bertuccini
- Kristen Berueda
- Amber Berumen Baker
All providers in Las Vegas, NV · Professional Counselor in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2026. 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.