Individual provider Active NPI

Conny Bruus, THERAPIST, LMSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1922776590
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096722 Issued in NY
Practice address
3136 Richmond Ter
Staten Island, NY 10303-1305
Phone
(347) 499-8901
NPI assigned
Aug 31, 2021
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 096722 NY Primary

Addresses

Primary practice location

3136 Richmond Ter
Staten Island, NY 10303-1305

Mailing address

3136 Richmond Ter
Staten Island, NY 10303-1305
Phone (347) 499-8901

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
096722NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Home Health Senior Care LLC Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1922776590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 RICHMOND TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031305",
            "telephone_number": "347-499-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 RICHMOND TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031305",
            "telephone_number": "347-499-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUUS",
        "first_name": "CONNY",
        "credential": "THERAPIST, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.