Individual provider Active NPI

Nora Brucklacher, M.A., LMFT

  • Mental Health Counselor
  • Reno, NV
National Provider Identifier
1255701652
Registry record updated Apr 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01444 Issued in NV
Practice address
855 S Center St Ste 101
Reno, NV 89501-2332
Phone
(775) 224-0703
Fax
(775) 333-9909
NPI assigned
Sep 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MI0474 NV
Mental Health Counselor 101YM0800X 01444 NV Primary

Addresses

Primary practice location

855 S Center St Ste 101
Reno, NV 89501-2332

Mailing address

855 S Center St Ste 101
Reno, NV 89501-2332
Phone (775) 224-0703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240227000966 NV Practitioner - Marriage and Family Therapist 3971964438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Sunrise Wellness Group LLCGroup PAC ID 2062873524, 5 clinicians

Practice addresses (Care Compare)

855 S Ctr St
Suite 101
Reno, NV 89501-2332
Phone (775) 440-1256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MI0474NVMDMental Health Counselor

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.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523059200000",
    "number": "1255701652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S CENTER ST STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895012332",
            "telephone_number": "775-224-0703",
            "fax_number": "775-333-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S CENTER ST STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895012332",
            "telephone_number": "775-224-0703",
            "fax_number": "775-333-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKLACHER",
        "first_name": "NORA",
        "name_prefix": "Mrs.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2018-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "MI0474",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "01444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.