Active NPI
Rebecca M Bruner, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1043294036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34004519A
- Practice address
- 8401 Harcourt Rd
Indianapolis, IN 46260-2036 - Phone
- (317) 338-4850
- NPI assigned
- Dec 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34004519A | IN | Primary |
Addresses
Primary practice location
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG4129 | Other | IN | RAILROAD GROUP |
| P00625949 | Other | IN | RAILROARD INDIVIDUAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004519A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1043294036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 HARCOURT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602036",
"telephone_number": "317-338-4850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNER",
"first_name": "REBECCA",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-02",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34004519A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD GROUP",
"identifier": "CG4129",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROARD INDIVIDUAL",
"identifier": "P00625949",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.