Active NPI
Haydee Olivas de Bermudez, LPC
- Mental Health Counselor
- Phoenix, AZ
National Provider Identifier
1477153799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 19283
- Practice address
- 3301 North 33Rd Ave.
Phoenix, AZ 85029 - Phone
- (602) 688-8868
- NPI assigned
- Oct 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 19283 | AZ | Primary |
Addresses
Primary practice location
3301 North 33Rd Ave.
Phoenix, AZ 85029
Mailing address
4209 S 76TH LN
Phoenix, AZ 85043-1410
Phone (480) 414-2035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19283 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1477153799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 S 76TH LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850431410",
"telephone_number": "480-414-2035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 NORTH 33RD AVE.",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85029",
"telephone_number": "602-688-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAS DE BERMUDEZ",
"first_name": "HAYDEE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-27",
"last_updated": "2021-02-25",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "19283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.