Jerrold Lee Brucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW014557 Issued in PA

Practice address

1101 Hillview Dr
Allentown, PA 18103-6046

Phone

(610) 730-2744

NPI assigned

Aug 9, 2006

Last updated

Apr 29, 2011By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christopher Hershman

  dba Covenant Counseling PC

  • Psychologist
  • Allentown, PA
  • NPI 1144356106
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1659381606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 S PIKE AVE",
            "address_2": "SUITE 104",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181037650",
            "telephone_number": "610-730-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HILLVIEW DR",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036046",
            "telephone_number": "610-730-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "JERROLD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070975930002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brownback, Mason and Associates
• Thomas Samuel Brownback, M.ED.
• Alysia Dawn Browne, M.D.
• Kara Leigh Browning, M.S. OTR/L
• Mary Grace Brownsberger, PSY.D., ABPP (RP)
• Jane Brunn, M.S., CCC-SLP/L
• Dante Bruno, MS, LPC
• Frank A. Bruno, CRNA
• John P Bruno, DO
• Kimberly Bruns, MSW, LCSW

• Clinical Social Worker in Allentown, PA
• Providers in Allentown, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.