Individual provider Active NPI

Myriam Liliana Bermudez, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1952044612
Registry record updated Oct 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
88163 Issued in TX
Practice address
16914 Silverwood Dr
San Antonio, TX 78232-2321
Phone
(210) 793-3311
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2023

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 88163 TX Primary

Addresses

Primary practice location

16914 Silverwood Dr
San Antonio, TX 78232-2321

Mailing address

16914 Silverwood Dr
San Antonio, TX 78232-2321
Phone (250) 826-9323

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
I20240125000516 TX Practitioner - Mental Health Counselor 0042663155 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88163TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Therapy LLC Professional CurrentSince Jan 16, 2024 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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697241600000",
    "number": "1952044612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16914 SILVERWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322321",
            "telephone_number": "250-826-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16914 SILVERWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322321",
            "telephone_number": "210-793-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "MYRIAM",
        "middle_name": "LILIANA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2023-10-14",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.