Nichole Bruder, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06666500 Issued in NJ

Practice address

700 Airport Rd
Lakewood, NJ 08701-5907

Phone

(732) 367-4700

NPI assigned

Jul 27, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Middlesex Psychiatry & TMS PC

  • Psychiatry Physician
  • Fairfield, NJ
  • NPI 1053971572
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1043983091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087018036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AIRPORT RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015907",
            "telephone_number": "732-367-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "NICHOLE",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06666500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0029807",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbruder@preferredbehavioral.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "700 Airport Rd",
            "city": "Lakewood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087015907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalia C Brown, RDN
• Nechama Brown, MS ED
• Tina Brown
• Yehudis Brown, MS CCC-SLP
• Chaya H Broyde
• Alex Brune
• Adina S Brus
• Daniel E. Brust, D.M.D
• Tracey Michelle Bruther, OTR
• Lannecie Brutus, WHNP-BC

• Social Worker in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.