Colette A Brunell, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05994 Issued in MD

Practice address

5550 Sterrett Plce
Suite 314
Columbia, MD 21044

Phone

(410) 730-6119

Fax

(410) 290-6550

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• Colette Brunell LCSW-C,BCD,LLC

  • Case Management Agency
  • Columbia, MD
  • NPI 1124410709
  Medicare reassignment NPD Authorized official
• Robert J. Temple, MD PA

  • Clinical Social Worker
  • Columbia, MD
  • NPI 1902907447
  NPD (past)
• Terrye a. Mowatt, M.D.

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1053505461
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1154415636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 MINUTE HAND COURT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-730-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 STERRETT PLCE",
            "address_2": "SUITE 314",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-730-6119",
            "fax_number": "410-290-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELL",
        "first_name": "COLETTE",
        "middle_name": "A",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05994",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "05994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC PLAN",
            "identifier": "36140003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI ID",
            "identifier": "30171",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "521885475",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD PLAN",
            "identifier": "42560901",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Bruder, PH.D.
• Madison Brumagin
• Rachel Leah Cohen Brumberger, L.AC.
• Alyssa Brumfield
• Kanesha Danee Brumfield, BCABA
• Carly Brunett
• Sandra Brunner, RN,BSN
• Francis C. Bruno, M.D.
• John Bruno
• Gretchen Faye Bruns, RN

• Clinical Social Worker in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.