Jenna Bruck, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MSW010868 Issued in GA

Practice address

3499 S Cobb Dr SE
Smyrna, GA 30080-4170

Phone

(770) 765-6094

NPI assigned

Dec 15, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1972215424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VICTORIAN LN",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975766",
            "telephone_number": "770-789-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804170",
            "telephone_number": "770-765-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCK",
        "first_name": "JENNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW010868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Wendell Brown, LPC
• Joi J Brown
• Karin Denise Brown, R.N.
• Matthew Brown
• Michaele L Brown, M.D
• Lauren Anne Brueck, ATC, LAT
• Leonide Brunot, APRN
• Bryan Demarco
• Lyla A Bryan, PMHNP-BC
• Christin Bryant, DDS

• Clinical Social Worker in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.