| Roxanne Brunsman Lcsw Llc | |
|
6524 Carrollton Ave Indianapolis IN 46220-1617 | |
| (765) 620-4628 | |
| (765) 683-9583 |
| Full Name | Roxanne Brunsman Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6524 Carrollton Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Roxanne Deneff Brunsman (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7656839583 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roxanne Brunsman Lcsw Llc 6173 N 100 W Alexandria IN 46001-8219 Ph: (765) 683-9583 | Roxanne Brunsman Lcsw Llc 6524 Carrollton Ave Indianapolis IN 46220-1617 Ph: (765) 620-4628 |
| NPI Number | 1760775480 |
|---|---|
| Provider Enumeration Date | 05/27/2011 |
| Last Update Date | 05/27/2011 |
| Medicare PECOS PAC ID | 1052584174 |
|---|---|
| Medicare Enrollment ID | O20111104000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760775480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34003970A (Indiana) | Primary |
| Provider Name | Roxanne D Brunsman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740212505 PECOS PAC ID: 6204995111 Enrollment ID: I20081106000885 |
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