Active NPI
Amber Brunelle, MSW LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1659747780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22929
- Practice address
- 1113 E Franklin Ave
Suite 203
Minneapolis, MN 55404-2974 - Phone
- (612) 721-0331
- Fax
- (612) 729-7834
- NPI assigned
- Aug 12, 2015
- Sex
- Female
- Sole proprietor
- No
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 Social Worker | 1041C0700X | 22929 | MN | Primary |
Addresses
Primary practice location
1113 E Franklin Ave
Suite 203
Minneapolis, MN 55404-2974
Mailing address
PO Box 704
Cass Lake, MN 56633-0704
Phone (218) 368-6233
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22929 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439337600000",
"number": "1659747780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 704",
"city": "CASS LAKE",
"state": "MN",
"postal_code": "566330704",
"telephone_number": "218-368-6233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1113 E FRANKLIN AVE",
"address_2": "SUITE 203",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042974",
"telephone_number": "612-721-0331",
"fax_number": "612-729-7834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNELLE",
"first_name": "AMBER",
"credential": "MSW LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-12",
"last_updated": "2015-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "22929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.