Healthcare Provider Details

I. General information

NPI: 1417636531
Provider Name (Legal Business Name): FRANCIS M BERMUDEZ LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 E GAYLON DR
TEMPE AZ
85282-2718
US

IV. Provider business mailing address

1727 E GAYLON DR
TEMPE AZ
85282-2718
US

V. Phone/Fax

Practice location:
  • Phone: 602-380-3023
  • Fax:
Mailing address:
  • Phone: 602-380-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-23740
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: