Provider Demographics
NPI:1982790887
Name:BRUN, NATALIE ANNE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:ANNE
Last Name:BRUN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WEST FOX ROAD
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560
Mailing Address - Country:US
Mailing Address - Phone:630-385-2058
Mailing Address - Fax:
Practice Address - Street 1:1240 IROQUOIS AVE
Practice Address - Street 2:SUITE #512 BRUN & ASSOCIATES COUNSELING
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8536
Practice Address - Country:US
Practice Address - Phone:630-355-9819
Practice Address - Fax:630-355-9821
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180000556101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
157230OtherMANAGED HEALTH NETWORK
IL04708544OtherBLUE CROSS BLUE SHIELD