Active NPI
J Kwame Bruce, MS, LPC, LSOTP
- Professional Counselor
- Round Rock, TX
National Provider Identifier
1336325893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19523
- Practice address
- 1110 Nottingham Hill Rd
Round Rock, TX 78664-7345 - Phone
- (512) 246-9664
- Fax
- (512) 246-9664
- NPI assigned
- Jan 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 19523 | TX | Primary |
Addresses
Primary practice location
1110 Nottingham Hill Rd
Round Rock, TX 78664-7345
Mailing address
1110 Nottingham Hill Rd
Round Rock, TX 78664-7345
Phone (512) 246-9664
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19523 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1336325893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 NOTTINGHAM HILL RD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786647345",
"telephone_number": "512-246-9664",
"fax_number": "512-246-9664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 NOTTINGHAM HILL RD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786647345",
"telephone_number": "512-246-9664",
"fax_number": "512-246-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "J",
"middle_name": "KWAME",
"credential": "MS, LPC, LSOTP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-15",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.