Bruno Anthony Niemitz, LCSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C000064 Issued in NC

Practice address

3937 Western Blvd
Raleigh, NC 27606-1936

Phone

(919) 821-0790

Fax

(919) 861-8961

NPI assigned

Nov 1, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Psych Support Inc.

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1699812651
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1992882351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33393",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276363393",
            "telephone_number": "919-821-0790",
            "fax_number": "919-861-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 WESTERN BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276061936",
            "telephone_number": "919-821-0790",
            "fax_number": "919-861-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMITZ",
        "first_name": "BRUNO",
        "middle_name": "ANTHONY",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000064",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "62601",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003333",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doris Maria Nicolas-Mir, RD
• Sarah Nidiffer
• Stephanie Gurganus Niedzwiecki, NP
• Carla Ludwigsen Nielsen
• Tanner Nielsen, DPT, PT
• Haiyun Tang Niemzyk
• Donna Nienstedt, OTR
• Karla Nicole Nieves Borrero, M.D.
• Edith Maria Nieves Lopez, M.D.
• David William Nightingale, D.D.S.

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; 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.