Individual provider Active NPI

Jessica Bruno, LMFT

  • Marriage & Family Therapist
  • Thomasville, NC
National Provider Identifier
1225510654
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2146 Issued in NC
Practice address
220 Laettner Dr
Thomasville, NC 27360
Phone
(336) 701-2136
NPI assigned
Sep 1, 2018
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12040A NC
Marriage & Family Therapist 106H00000X 2146 NC Primary

Addresses

Primary practice location

220 Laettner Dr
Thomasville, NC 27360

Mailing address

PO Box 2832
Thomasville, NC 27361-2832
Phone (336) 701-2136

Other practice location 1

5521 Grapevine Ct
Greensboro, NC 27405
Phone (336) 501-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250620001801 NC Practitioner - Marriage and Family Therapist 1658883228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

5801 Executive Ctr Dr
Charlotte, NC 28212-8861
Phone (704) 863-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12040ANCMDMarriage & Family Therapist
2146NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Multi-Specialty CurrentSince Apr 28, 2025 Accepting new patients
Carolinas Physicians Network Inc Multi-Specialty CurrentSince Apr 28, 2025 Accepting new patients
Carolinas Physicians Network Inc Multi-Specialty Current Accepting new patients
House Call Services Marriage & Family Therapist CurrentSince Jun 22, 2021 Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

5801 Executive Center Dr
Charlotte, NC 28212
Phone (704) 863-1550

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1225510654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2832",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273612832",
            "telephone_number": "336-701-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LAETTNER DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "27360",
            "telephone_number": "336-701-2136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5521 Grapevine Ct",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "27405",
            "country_code": "US",
            "telephone_number": "336-501-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "JESSICA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-01",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12040A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "2146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.