Judy Kay Brunsgaard, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19209 Issued in MN

Practice address

7236 Forestview LN N
Maple Grove, MN 55369-5656

Phone

(763) 416-4167

Fax

(763) 416-4137

NPI assigned

Dec 27, 2011

Last updated

Dec 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Psychological Consultants, LLCGroup PAC ID 3678596285, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innovative Psychological Consultants, LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Maple Grove, MN
  • NPI 1942221080
  Medicare reassignment Care Compare group NPD
• Right Mind Counseling Services, PLLC

  • Clinical Social Worker
  • Fridley, MN
  • NPI 1154852663
  NPD (past) Authorized official

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449964800000",
    "number": "1306115969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7236 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695656",
            "telephone_number": "763-416-4167",
            "fax_number": "763-416-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7236 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695656",
            "telephone_number": "763-416-4167",
            "fax_number": "763-416-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSGAARD",
        "first_name": "JUDY",
        "middle_name": "KAY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2015-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7902-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306115969",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace A. Brown, OD
• Patricia Fitzgerald Brown
• Kathleen Brunick, OTR
• Alex Bruning
• Natalie Marie Bruno
• Michael Benjamin Buchman, LGSW
• Jill Noel Buechler, RPH
• Emily Anne Buell, CTRS
• Carol Buendorf
• Lynette Burch

• Clinical Social Worker in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.