Michael Brudzinski, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

BH006047 Issued in PA

Practice address

111 Elwyn Rd
Elwyn, PA 19063-4622

Phone

(610) 891-7007

NPI assigned

Aug 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Elwyn of Pennsylvania and Delaware

  • Community/Behavioral Health Agency
  • Media, PA
  • NPI 1215548615
  NPD (past)

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1992351787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-7007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Green Ln",
            "address_purpose": "LOCATION",
            "city": "Aston",
            "state": "PA",
            "postal_code": "190142002",
            "country_code": "US",
            "telephone_number": "773-865-4452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUDZINSKI",
        "first_name": "MICHAEL",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "BH006047",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://elwyn.account.box.com",
            "affiliation": "Y",
            "affiliationName": "Elwyn of Pennsylvania and Delaware",
            "address_1": "111 Elwyn Rd",
            "city": "Elwyn",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190634622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Franceska Benedetto, MS, OT
• Jennifer Brandt, PT
• Stephanie Bruno, SLP
• Michele Chapman, MA FAAA
• Ellen Chung, LCSW
• Candice Denise Coston
• Ellen Delea, MD

• Mental Health Counselor in Elwyn, PA
• Providers in Elwyn, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.