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NPI Code Detail

MEDICARE: INGRID M BRUMMET, LLC

MEDICARE: INGRID M BRUMMET, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1407556087
Entity Type Code : Organization
Provider Name (Legal Business Name) : INGRID M BRUMMET, LLC
Provider Business Mailing Address
First Line : 1 KALISA WAY STE 101
Second Line :
City : PARAMUS
State : NJ
Zip : 07652-3508
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Provider Business Practice Location Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Authorized Official
Title or Position : LCSW
Name : INGRID M BRUMMET
Credential : MSW
Telephone Number : 970-443-3450
Provider Enumeration Date : 03/03/2023
Last Update Date : 03/03/2023

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