Provider Demographics
NPI:1467743625
Name:BRUNS, JOEL D
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:BRUNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E CARMEL DR
Mailing Address - Street 2:SUITE 154
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2803
Mailing Address - Country:US
Mailing Address - Phone:303-718-7827
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR
Practice Address - Street 2:SUITE 154
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2803
Practice Address - Country:US
Practice Address - Phone:303-718-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health