Jean Brunk LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JEAN BRUNK LCSW LLC

Practice address

117 S 5TH St
Goshen, IN 46528-3711

Phone

(574) 231-7010

Fax

(574) 231-7135

NPI assigned

Mar 8, 2023

Organization subpart

No

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

Authorized official

Name

Jean Brunk, LCSWNPI 1710130810

Title

Owner

Phone

(574) 238-7849

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean G Brunk, LCSW

  • Clinical Social Worker
  • Goshen, IN
  • NPI 1710130810
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1124728019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-231-7010",
            "fax_number": "574-231-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-231-7010",
            "fax_number": "574-231-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN BRUNK LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "BRUNK",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-238-7849",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jankowski
• Andrea Jaramillo, DO
• Jaress Family Dentistry PC
• Amber Michelle Jaress, DDS
• Jason Miller Counseling LLC
• Jean Miller LCSW LLC
• Jefferson TWP Elkhart Co
• Jeffrey P. Bolduan, M.D. Inc
• Jennifer Miller Counseling, PC
• Keith D Jodway, LMHC, LCAC

• Clinical Social Worker in Goshen, IN
• Providers in Goshen, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.