Active NPI
Rosemary Brucken, PSY.D.
- Clinical Psychologist
- Rowlett, TX
National Provider Identifier
1528019320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5657
- Practice address
- 9617 Castleroy LN
Rowlett, TX 75089-8366 - Phone
- (937) 657-0019
- NPI assigned
- May 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5657 | OH | Primary |
Addresses
Primary practice location
9617 Castleroy LN
Rowlett, TX 75089-8366
Mailing address
PO Box 2147
Rowlett, TX 75030-2147
Phone (937) 657-0019
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000391396 | Other | OH | ANTHEM BC BS |
| 680015634 | Other | OH | RAILROAD MEDICARE |
| 2365748 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36467 | TX | MD | Pharmacy Technician |
| 5657 | OH | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transitional Living | 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.
-
- Community/Behavioral Health Agency
- Fairfield Township, OH
- NPI 1689631046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1528019320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750302147",
"telephone_number": "937-657-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9617 CASTLEROY LN",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750898366",
"telephone_number": "937-657-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCKEN",
"first_name": "ROSEMARY",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-15",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "000000391396",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "680015634",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2365748",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.