Jean G Brunk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34001362A Issued in IN

Practice address

117 S 5TH St
Goshen, IN 46528-3711

Phone

(574) 231-7010

Fax

(574) 231-7135

NPI assigned

Nov 3, 2008

Last updated

Mar 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jean Brunk LCSW LLC

  • Clinical Social Worker
  • Goshen, IN
  • NPI 1124728019
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1710130810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-231-7010",
            "fax_number": "574-231-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 5TH ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465283711",
            "telephone_number": "574-231-7010",
            "fax_number": "574-231-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNK",
        "first_name": "JEAN",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001362A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Brown, NCC
• Kendall Brown, MSW
• Maria L Brown, R.D.
• Megan Lee Brown, DC
• Hannah Brundage, DO
• Makenzee Leeann Budd
• Stephen Budzinski
• Paul H Buller, MD
• Jeffrey S Burden, DDS
• Robert D Burke

• Clinical Social Worker in Goshen, IN
• Providers in Goshen, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.