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General NPI Number Information
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NPI Number | 1548130578
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Entity Type | Individual
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Provider Name | BERN CAREY ROBERTS
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Gender | Male
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 1355 S HIGLEY RD
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City | GILBERT
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State | AZ
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Zip | 85296-4799
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Country | US
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Telephone | 602-882-3192
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Fax |
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Provider Business Mailing Address
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Address Line | 10527 E LAGUNA AZUL AVE
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City | MESA
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State | AZ
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Zip | 85209-1522
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Country | US
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Telephone | 602-882-3192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LAX-08350T
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License Number State | AZ
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