Provider Demographics
NPI:1780840512
Name:BRUNS, CHERYL (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:MICHELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2198 OAK FOREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1966
Mailing Address - Country:US
Mailing Address - Phone:410-218-8246
Mailing Address - Fax:410-366-8530
Practice Address - Street 1:8370 COURT AVE
Practice Address - Street 2:#200
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-218-8246
Practice Address - Fax:410-571-8368
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018529900Medicaid
MD138690YYDMedicare PIN