Individual provider Active NPI

Paul Michael Brunner, MSW, LCSW

  • Social Worker
  • Walsenburg, CO
National Provider Identifier
1659517837
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
C007062 Issued in NC
Practice address
538 Rugby Mines Rd
Walsenburg, CO 81089-9756
Phone
(910) 574-3515
NPI assigned
Dec 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09926354 CO
Clinical Social Worker 1041C0700X P-0004680 NC
Clinical Social Worker 1041C0700X C 007062 NC
Social Worker 104100000X C007062 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X P004680 NC

Addresses

Primary practice location

538 Rugby Mines Rd
Walsenburg, CO 81089-9756

Mailing address

538 Rugby Mines Rd
Walsenburg, CO 81089-9756
Phone (910) 574-3515

Other practice location 1

216 W Routt Ave
Pueblo, CO 81004-1844
Phone (910) 574-3615

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
P004680NCMDAddiction (Substance Use Disorder) Counselor
C007062NCMDSocial Worker
CSW.09926354COMDClinical Social Worker
C 007062NCMDClinical Social Worker
P-0004680NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1659517837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 RUGBY MINES RD",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899756",
            "telephone_number": "910-574-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 RUGBY MINES RD",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899756",
            "telephone_number": "910-574-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 W Routt Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810041844",
            "country_code": "US",
            "telephone_number": "910-574-3615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-18",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926354",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P-0004680",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C 007062",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C007062",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "P004680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walsenburg, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.