Provider Demographics
NPI:1356633580
Name:BRUCALE, KIMBERLY (LPC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:BRUCALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FOREST ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6529
Mailing Address - Country:US
Mailing Address - Phone:973-652-5351
Mailing Address - Fax:
Practice Address - Street 1:47 FOREST ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6529
Practice Address - Country:US
Practice Address - Phone:973-652-5351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00417400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional