Ethan Brudno, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC01099500 Issued in NJ

Practice address

103 Old Marlton Pike Ste 101
Medford, NJ 08055-8772

Phone

(609) 314-1807

NPI assigned

Feb 3, 2025

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peaceful Practices Counseling LLCGroup PAC ID 5698114650, 10 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.

• Peaceful Practices Counseling LLC

  • Professional Counselor
  • Medford, NJ
  • NPI 1457978017
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1346054228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 ROUTE 70 W APT A",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE STE 101",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558772",
            "telephone_number": "609-314-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDNO",
        "first_name": "ETHAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC01099500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Brook, LCSW
• Alexa Rae Brown, DPT
• Ingrid Brown, PA-C
• Theresa Brown
• Lois E Browning, DMD
• Giana Brunetti, PA-C
• Jennifer L Buccigrossi, MD
• Andrea Sue Buck, DO
• Johanna Marie Buckingham, PT
• Jaclyn Buckley, PT, DPT

• Professional Counselor in Medford, NJ
• Providers in Medford, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.