Individual provider Active NPI

Bernadette Bruha, LPC

  • Mental Health Counselor
  • Peoria, AZ
National Provider Identifier
1487254629
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-19013 Issued in AZ
Practice address
10028 W Redbird Rd
Peoria, AZ 85383-3368
Phone
(505) 259-3104
NPI assigned
Oct 27, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-19013 AZ Primary

Addresses

Primary practice location

10028 W Redbird Rd
Peoria, AZ 85383-3368

Mailing address

20403 N Lake Pleasant Rd Ste 117-268
Peoria, AZ 85382-9702
Phone (505) 259-3104

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

LicenseStateTypeSpecialty
LPC-19013AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
First Responder Counseling, LLC Mental Health CurrentSince Nov 15, 2020 Accepting new patients

Locations

20403 N Lake Pleasant Rd
Ste 117268
Peoria, AZ 85382

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1603756800000",
    "number": "1487254629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20403 N LAKE PLEASANT RD STE 117-268",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829702",
            "telephone_number": "505-259-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10028 W REDBIRD RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833368",
            "telephone_number": "505-259-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUHA",
        "first_name": "BERNADETTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-19013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.