Individual provider Active NPI

Glenda Bruno, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1629380407
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23142-TRAINEE Issued in NY
Practice address
2410 Amsterdam Ave
4TH Floor
New York, NY 10033-7320
Phone
(917) 258-3682
Fax
(212) 740-7065
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23142-TRAINEE NY Primary

Addresses

Primary practice location

2410 Amsterdam Ave
4TH Floor
New York, NY 10033-7320

Mailing address

2410 Amsterdam Ave
4TH Floor
New York, NY 10033-7320
Phone (917) 258-3682

Other identifiers 1

IdentifierTypeStateIssuer
23142-TRAINEEOtherNYTRAINEE CERTIFICATE

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

State licenses

LicenseStateTypeSpecialty
23142-TRAINEENYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alianza Dominicana, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1629380407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 AMSTERDAM AVE",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100337320",
            "telephone_number": "917-258-3682",
            "fax_number": "212-740-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 AMSTERDAM AVE",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100337320",
            "telephone_number": "917-258-3682",
            "fax_number": "212-740-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "GLENDA",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "23142-TRAINEE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINEE CERTIFICATE",
            "identifier": "23142-TRAINEE",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.