Active NPI
Brenda Russell Dunn, LCSW
- Clinical Social Worker
- Lufkin, TX
National Provider Identifier
1699856435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16181
- Practice address
- 3402 Daniel McCall Dr Ste 21
Lufkin, TX 75904-7191 - Phone
- (936) 637-3300
- Fax
- (936) 634-3384
- NPI assigned
- Oct 18, 2006
- 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 | 16181 | TX | Primary |
Addresses
Primary practice location
3402 Daniel McCall Dr Ste 21
Lufkin, TX 75904-7191
Mailing address
3402 Daniel McCall Dr Ste 21
Lufkin, TX 75904-7191
Phone (936) 633-6245
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133330409 | Medicaid | TX | |
| 071381003 | Medicaid | TX |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16181 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buckner Children & Family Services, Inc. | Past | Accepting new patients | |
| Buckner Children & Family Services of Deep East Texas | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Lufkin, TX
- NPI 1215070362
-
- Case Management Agency
- Beaumont, TX
- NPI 1639246143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322179200000",
"number": "1699856435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3402 DANIEL MCCALL DR STE 21",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759047191",
"telephone_number": "936-633-6245",
"fax_number": "936-634-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3402 DANIEL MCCALL DR STE 21",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759047191",
"telephone_number": "936-637-3300",
"fax_number": "936-634-3384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "BRENDA",
"middle_name": "RUSSELL",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2011-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "16181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133330409",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071381003",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.