Provider Demographics
NPI:1578262580
Name:BRUMMELL COUNSELING, LLC
Entity Type:Organization
Organization Name:BRUMMELL COUNSELING, LLC
Other - Org Name:BRUMMELL COUNSELING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST/OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMMELL
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-341-7474
Mailing Address - Street 1:1505 KASOLD DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-1601
Mailing Address - Country:US
Mailing Address - Phone:785-341-7474
Mailing Address - Fax:
Practice Address - Street 1:1505 KASOLD DR STE 3
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1601
Practice Address - Country:US
Practice Address - Phone:785-341-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1174084545OtherLSCSW