MEDICARE: JANICE VANBRUNT LLMSW

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
1	1041C0700X	Clinical Social Worker	6851120776	MI

General Provider Information

NPI Number	:	1649993908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE VANBRUNT LLMSW

Provider Business Mailing Address
First Line	:	2792 N ADRIAN HWY STE 1
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-1158
Country	:	US
Telephone Number	:	734-331-8560
Fax Number	:

Provider Business Practice Location Address
First Line	:	2792 N ADRIAN HWY STE 1
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-1158
Country	:	US
Telephone Number	:	734-331-8560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2022
Last Update Date	:	03/24/2026

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