Healthcare Provider Details

I. General information

NPI: 1477467769
Provider Name (Legal Business Name): RUBEN BERMEA COUNSELING AND CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 S HAVANA ST APT 334
ENGLEWOOD CO
80111-5647
US

IV. Provider business mailing address

1500 N GRANT ST # 4182
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 254-462-5401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. RUBEN DAVID BERMEA JR.
Title or Position: OWNER
Credential: LPC
Phone: 254-462-5401