| Brungard Counseling Services | |
|
489 Main St Suite 102 Prince Frederick MD 20678-3187 | |
| (443) 968-9266 | |
| (410) 414-5911 |
| Full Name | Brungard Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 489 Main St, Prince Frederick, Maryland |
| Authorized Official Name and Position | Robin Brungard (OWNER) |
| Authorized Official Contact | 4439689266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brungard Counseling Services Po Box 1631 Prince Frederick MD 20678-1631 Ph: (443) 968-9266 | Brungard Counseling Services 489 Main St Suite 102 Prince Frederick MD 20678-3187 Ph: (443) 968-9266 |
| NPI Number | 1376909572 |
|---|---|
| Provider Enumeration Date | 01/05/2016 |
| Last Update Date | 02/27/2017 |
| Medicare PECOS PAC ID | 6507149622 |
|---|---|
| Medicare Enrollment ID | O20170215000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376909572 | NPI | - | NPPES |
| 402796500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11218 (Maryland) | Primary |
| Provider Name | Robin C Brungard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962403337 PECOS PAC ID: 4284703265 Enrollment ID: I20080516000118 |
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