Individual provider Active NPI

Bernadette Ontiveros, LPC

  • Professional Counselor
  • El Paso, TX
National Provider Identifier
1740418169
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75206 Issued in TX
Practice address
11710 Pebble Hills Blvd
El Paso, TX 79936-0802
Phone
(915) 533-7057
Fax
(905) 533-7158
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0122331 NM
Professional Counselor 101YP2500X 75206 TX Primary

Addresses

Primary practice location

11710 Pebble Hills Blvd
El Paso, TX 79936-0802

Mailing address

3607 Rivera Ave
El Paso, TX 79905-2415
Phone (915) 533-7057

Other practice location 1

6621 Doniphan Dr Ste G
Canutillo, TX 79835-5005
Phone (915) 877-5100

Other identifiers 1

IdentifierTypeStateIssuer
VNM01103NIOtherNMVALUE OPTIONS

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
I20260408002958 TX Practitioner - Mental Health Counselor 3072088970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 N Lee Trevino Dr
Suite C3
El Paso, TX 79936-5164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0122331NMMDAddiction (Substance Use Disorder) Counselor
75206TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Passage Counseling LLC Professional Current Accepting new patients
Sunwest Behavioral Associates PA Past Accepting new patients

Locations

1600 N Lee Trevino Dr
Ste C3
El Paso, TX 79936
Phone (915) 598-2190

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1740418169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 RIVERA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052415",
            "telephone_number": "915-533-7057",
            "fax_number": "915-533-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 PEBBLE HILLS BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799360802",
            "telephone_number": "915-533-7057",
            "fax_number": "905-533-7158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Doniphan Dr Ste G",
            "address_purpose": "LOCATION",
            "city": "Canutillo",
            "state": "TX",
            "postal_code": "798355005",
            "country_code": "US",
            "telephone_number": "915-877-5100",
            "fax_number": "915-877-5107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONTIVEROS",
        "first_name": "BERNADETTE",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0122331",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "VNM01103NI",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.