William Bruinsma, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2004152 Issued in IN

Practice address

1000 S Michigan St
South Bend, IN 46601-3426

Phone

(574) 339-4419

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rite of Passage, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • South Bend, IN
  • NPI 1073993002
  NPD (past)

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1598145484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 BUSINESS PKWY",
            "address_2": "SUITE A",
            "city": "MINDEN",
            "state": "NV",
            "postal_code": "894238985",
            "telephone_number": "574-339-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013426",
            "telephone_number": "574-339-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINSMA",
        "first_name": "WILLIAM",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "2004152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Ann Brubaker
• Wendy Dawn Bruce, PT
• Bruening Therapy LLC
• Karen Bruening, MS
• Kaylie Bruinsma, MSW
• Ellen Bruneel, OTR
• Mary Joan Brunner
• Seth David Brunner, DPT
• Ashley Brunt, LSW
• Randy Joseph Brush, P.A.

• Psychologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.