Active NPI
Jayson Michael Brunelle, M.ED. CAGS
- Professional Counselor
- Coventry, CT
National Provider Identifier
1669634549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 004765
- Practice address
- 28 Armstrong Rd Apt C27
Coventry, CT 06238-3361 - Phone
- (860) 207-0517
- NPI assigned
- Jul 1, 2008
- Last updated
- Sep 3, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 004765 | CT | Primary |
Addresses
Primary practice location
28 Armstrong Rd Apt C27
Coventry, CT 06238-3361
Mailing address
28 Armstrong Rd Apt C27
Coventry, CT 06238-3361
Phone (860) 207-0517
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004765 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1669634549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 ARMSTRONG RD APT C27",
"city": "COVENTRY",
"state": "CT",
"postal_code": "062383361",
"telephone_number": "860-207-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 ARMSTRONG RD APT C27",
"city": "COVENTRY",
"state": "CT",
"postal_code": "062383361",
"telephone_number": "860-207-0517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNELLE",
"first_name": "JAYSON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "M.ED. CAGS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-01",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "004765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coventry, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.