Individual provider Active NPI

Lauren Berdeguez, LCPC

  • Professional Counselor
  • Ellicott City, MD
National Provider Identifier
1508480955
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC12292 Issued in MD
Practice address
10045 Baltimore National Pike
Ellicott City, MD 21042-3673
Phone
(443) 396-2799
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC12292 MD Primary
Mental Health Counselor 101YM0800X LC12292 MD

Addresses

Primary practice location

10045 Baltimore National Pike
Ellicott City, MD 21042-3673

Mailing address

4014 Iroquois Dr
Westminster, MD 21157-7825
Phone (410) 371-3596

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
LC12292MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Beautiful Minds Therapy Services Current Accepting new patients

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1508480955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 IROQUOIS DR",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577825",
            "telephone_number": "410-371-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423673",
            "telephone_number": "443-396-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDEGUEZ",
        "first_name": "LAUREN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12292",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.