Provider Demographics
NPI:1417500612
Name:BRUNS, JAMES BERNARD JR (MC, LADC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BERNARD
Last Name:BRUNS
Suffix:JR
Gender:M
Credentials:MC, LADC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:319 E HIGHWAY 12 STE 1
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-2262
Mailing Address - Country:US
Mailing Address - Phone:320-557-6996
Mailing Address - Fax:866-871-9965
Practice Address - Street 1:319 E HIGHWAY 12 STE 1
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-2262
Practice Address - Country:US
Practice Address - Phone:320-557-6996
Practice Address - Fax:866-871-9965
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302696101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)