Daniel T Bernal

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

11680 S 153Rd West Ave
Sapulpa, OK 74066-8564

Phone

(918) 512-6273

NPI assigned

Apr 14, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Lifegate Freedom Recovery Ministries, Inc.

  • Substance Abuse Rehabilitation Facility
  • Sapulpa, OK
  • NPI 1073103701
  NPD

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1659014090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11680 S 153RD WEST AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740668564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11680 S 153RD WEST AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740668564",
            "telephone_number": "918-512-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "DANIEL",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "09-194-1801",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thebestdtbyet@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11680 S 153rd West Ave",
            "city": "Sapulpa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740668564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katresse Bedwell
• John C Bell, LPC
• Logan Belveal
• Juliann Shalee Bennett
• Christopher Alan Bentley, LPC
• Stacey Maxwell Berry
• Caitlen Denise Berryhill
• Cassandra Bertalott, SLP
• Teresa Besses, MS
• Chelsea Bethel

• Peer Specialist in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.