Individual provider Active NPI

Brian Jermoe Van Brunt, EDD

  • Mental Health Counselor
  • Henniker, NH
National Provider Identifier
1205047669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
306 Issued in NH
Practice address
24 Bridge St
Henniker, NH 03242-3202
Phone
(603) 491-3215
NPI assigned
May 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 306 NH Primary

Addresses

Primary practice location

24 Bridge St
Henniker, NH 03242-3202

Mailing address

PO Box 391
Henniker, NH 03242-0391
Phone (603) 491-3215

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

LicenseStateTypeSpecialty
306NHMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205047669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391",
            "city": "HENNIKER",
            "state": "NH",
            "postal_code": "032420391",
            "telephone_number": "603-491-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 BRIDGE ST",
            "city": "HENNIKER",
            "state": "NH",
            "postal_code": "032423202",
            "telephone_number": "603-491-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BRUNT",
        "first_name": "BRIAN",
        "middle_name": "JERMOE",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henniker, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.