Individual provider Active NPI

Bernadette Vanessa Trevizo, LPC

  • Professional Counselor
  • El Paso, TX
National Provider Identifier
1679878441
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
6040 Surety Dr
El Paso, TX 79905-2043
Phone
(915) 781-9900
NPI assigned
Jan 25, 2011
Last updated
Sep 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

6040 Surety Dr
El Paso, TX 79905-2043

Mailing address

6040 Surety Dr
El Paso, TX 79905-2043
Phone (915) 781-9900

Other identifiers 1

IdentifierTypeStateIssuer
382651301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001705 TX Practitioner - Mental Health Counselor 0749632271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso Counseling Center of Expressive Arts PCGroup PAC ID 2466736863, 6 clinicians

Practice addresses (Care Compare)

1600 Medical Ctr Dr
Suite B 1
El Paso, TX 79902-5002
Phone (915) 845-3122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Counseling Center of Expressive Arts PC Professional CurrentSince Jan 1, 2024 Accepting new patients
Family Service of El Paso Professional PastSince Oct 13, 2016 Accepting new patients

Organizations & group practices 2

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": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1679878441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 SURETY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052043",
            "telephone_number": "915-781-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SURETY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052043",
            "telephone_number": "915-781-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVIZO",
        "first_name": "BERNADETTE",
        "middle_name": "VANESSA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382651301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.