MEDICARE: LAURELL BERTINO LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	CP6032-R	NV
2	261QP2400X	Prison Health Clinic/Center
3	101YM0800X	Mental Health Counselor
4	221700000X	Art Therapist		CA
5	101YP2500X	Professional Counselor	5785	CA

General Provider Information

NPI Number	:	1306201751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURELL BERTINO LPCC

Provider Business Mailing Address
First Line	:	27 E AGATE AVE UNIT 303
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-6069
Country	:	US
Telephone Number	:	209-584-4122
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 E AGATE AVE UNIT 303
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-6069
Country	:	US
Telephone Number	:	209-584-4122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	03/17/2026

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Directions to “ LAURELL BERTINO LPCC” Practice Location

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