Individual provider Active NPI

Sara D Bruhn, LCSW LPC LMFT

  • Clinical Social Worker
  • Huntsville, TX
National Provider Identifier
1124181144
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06030 Issued in TX
Practice address
2804 Lake Rd Ste 1
Huntsville, TX 77340-5626
Phone
(936) 291-7928
Fax
(936) 294-0164
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 00038604261 TX
Clinical Social Worker 1041C0700X 06030 TX Primary
Mental Health Counselor 101YM0800X 5061 TX

Addresses

Primary practice location

2804 Lake Rd Ste 1
Huntsville, TX 77340-5626

Mailing address

2804 Lake Rd Ste 1
Huntsville, TX 77340-5626
Phone (936) 291-7928

Other identifiers 2

IdentifierTypeStateIssuer
562JOtherTXBCBS
064171401MedicaidTX

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

LicenseStateTypeSpecialty
06030TXMDClinical Social Worker
00038604261TXMDMarriage & Family Therapist
5061TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prevail Counseling & Forensic Mental Health Consulting, P.C. Mental Health Past Accepting new patients
Prevail Counseling and Forensic Mental Health, Mental Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1124181144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 LAKE RD STE 1",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405626",
            "telephone_number": "936-291-7928",
            "fax_number": "936-294-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 LAKE RD STE 1",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405626",
            "telephone_number": "936-291-7928",
            "fax_number": "936-294-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUHN",
        "first_name": "SARA",
        "middle_name": "D",
        "credential": "LCSW LPC LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "00038604261",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "06030",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "5061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "562J",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064171401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.