Active NPI
Kevin J Bruner, LPC
- Professional Counselor
- Wylie, TX
National Provider Identifier
1235306978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 62714
- Practice address
- 100 N 1St St
Wylie, TX 75098-4473 - Phone
- (469) 757-4525
- Fax
- (469) 757-4525
- NPI assigned
- May 12, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 62714 | TX | Primary |
Addresses
Primary practice location
100 N 1St St
Wylie, TX 75098-4473
Mailing address
714 Ireland Way
Wylie, TX 75098-6011
Phone (469) 757-4525
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 |
|---|---|---|---|
| 62714 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wylie Counseling Associates, PLLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Wylie, TX
- NPI 1205086295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415750400000",
"number": "1235306978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 IRELAND WAY",
"city": "WYLIE",
"state": "TX",
"postal_code": "750986011",
"telephone_number": "469-757-4525",
"fax_number": "469-757-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N 1ST ST",
"city": "WYLIE",
"state": "TX",
"postal_code": "750984473",
"telephone_number": "469-757-4525",
"fax_number": "469-757-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNER",
"first_name": "KEVIN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-12",
"last_updated": "2014-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "62714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wylie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.