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MR. JERROLD LEE BRUCKER LCSW NPI 1659381606


NPI Information

NPI: 1659381606
Provider Name: MR. JERROLD LEE BRUCKER, LCSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
1101 HILLVIEW DR
ALLENTOWN, PA
ZIP 18103
Phone: (610) 730-2744
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MR. Jerrold Lee Brucker, LCSW is a clinical social worker in Allentown, PA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MR. Jerrold Lee Brucker, LCSW NPI is 1659381606. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1101 HILLVIEW DR
ALLENTOWN, PA
ZIP 18103-046
Phone: (610) 730-2744

The NPI 1659381606 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 8/9/2006 and was last updated on 4/29/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalCW014557PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1R06879MEDICARE UPINPENNSYLVANIA
20070975930002MEDICAIDPENNSYLVANIA
3421219MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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