Cornell J. Brunson, MS, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00095400 Issued in NJ

Practice address

2630 E Chestnut Ave
Suite D-4
Vineland, NJ 08361-8400

Phone

(856) 776-6649

Fax

(856) 696-4799

NPI assigned

Nov 5, 2007

Last updated

Nov 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1932389251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 NEW PEAR ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603940",
            "telephone_number": "856-776-6649",
            "fax_number": "856-696-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E CHESTNUT AVE",
            "address_2": "SUITE D-4",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083618400",
            "telephone_number": "856-776-6649",
            "fax_number": "856-696-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "CORNELL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "MS, LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00095400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "11767849",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Brown, DO
• Carrie L Bruce
• Scott Bruggeworth, D.M.D
• Christopher Ryan Bruno, MD
• Laura J Bruno, L.C.S.W.
• Bromiley Bryan
• Rachel Ann Bryant
• Samuel Bucek
• Stacen Buchholz, DO
• Gary B Buck, MD

• Addiction (Substance Use Disorder) Counselor in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.