MEDICARE: JENNIFER BERTRAND, LPC, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1235855255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER BERTRAND, LPC, PLLC

Provider Business Mailing Address
First Line	:	24819 PROVIDENCE HEIGHTS WAY
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3505
Country	:	US
Telephone Number	:	281-704-3743
Fax Number	:

Provider Business Practice Location Address
First Line	:	12808 W AIRPORT BLVD STE 275L
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-6245
Country	:	US
Telephone Number	:	832-449-8467
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER NAVARRO
Credential	:
Telephone Number	:	281-704-3743

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	06/26/2023

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