Active NPI
Charlie Brunt
- Counselor
- College Station, TX
National Provider Identifier
1174359228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPCC.0020759
- Practice address
- 4340 Decatur Dr Apt 6105
College Station, TX 77845-9755 - Phone
- (970) 699-2424
- NPI assigned
- Sep 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPCC.0020759 | CO | Primary |
Addresses
Primary practice location
4340 Decatur Dr Apt 6105
College Station, TX 77845-9755
Mailing address
4340 Decatur Dr Apt 6105
College Station, TX 77845-9755
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0020759 | CO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1174359228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4340 DECATUR DR APT 6105",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778459755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4340 DECATUR DR APT 6105",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778459755",
"telephone_number": "970-699-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNT",
"first_name": "CHARLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-13",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "LPCC.0020759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.