Provider Demographics
NPI:1891032579
Name:BRUNS, KIMBERLY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:MORITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:82 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1014
Mailing Address - Country:US
Mailing Address - Phone:484-221-3692
Mailing Address - Fax:484-460-2470
Practice Address - Street 1:1011 BROOKSIDE RD STE 122
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9020
Practice Address - Country:US
Practice Address - Phone:610-569-0252
Practice Address - Fax:484-460-2470
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0144951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical