MEDICARE: MR. DANIEL ALLEN BERARDUCCI CPC, ACS

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	101YM0800X	Mental Health Counselor	CP0071	NV
2	101YP2500X	Professional Counselor	CP0071	NV

General Provider Information

NPI Number	:	1255657029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL ALLEN BERARDUCCI CPC, ACS

Provider Business Mailing Address
First Line	:	PO BOX 35586
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5586
Country	:	US
Telephone Number	:	702-518-4532
Fax Number	:

Provider Business Practice Location Address
First Line	:	7041 SUNHAMPTON AVE UNIT 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-1735
Country	:	US
Telephone Number	:	702-518-4532
Fax Number	:

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

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	07/30/2024

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