1. Home
  2. Directory
  3. Indiana
  4. Goshen
  5. Social Worker
  6. NPI Profile

JEAN BRUNK LCSW LLC
NPI 1124728019
Social Worker - Clinical in Goshen, IN

Active since March 08, 2023
117 S 5TH ST, GOSHEN, IN 46528(574) 231-7010(574) 231-7135 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jean Brunk Lcsw Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAN BRUNK LCSW LLC (NPI 1124728019) is a healthcare organization registered as a clinical in Goshen, Indiana and active in the NPI registry since March 2023. The organization lists Jean Brunk, Owner, as its authorized official.

NPPES Registry Identity

NPI1124728019
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameJEAN BRUNK LCSW LLC
Location Address117 S 5TH STGoshen, IN 46528-3711
Mailing Address117 S 5th StGoshen, IN 46528-3711 · (574) 231-7010 · Fax (574) 231-7135
Phone(574) 231-7010
Fax(574) 231-7135
Organization SubpartNo
Authorized OfficialJean BrunkOwner · (574) 238-7849
Enumeration DateMarch 8, 2023
NPPES CertifiedMarch 8, 2023
✔ NPI 1124728019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
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.
117 S 5TH ST, Goshen, IN 46528
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean Brunk Lcsw Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jean Brunk Lcsw LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jean Brunk, LCSW
Clinical Social Worker
NPI 1710130810
117 S 5TH ST
Goshen, IN 46528
(574) 231-7010
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jean Brunk Lcsw LLC's NPI number?

The NPI number for Jean Brunk Lcsw LLC is 1124728019. It was assigned to this organization in the NPPES registry on March 8, 2023.

Where is Jean Brunk Lcsw LLC located?

Jean Brunk Lcsw LLC is located at 117 S 5th St, Goshen, IN 46528. The listed phone number is (574) 231-7010.

What is Jean Brunk Lcsw LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jean Brunk Lcsw LLC enrolled in Medicare?

Yes. Jean Brunk Lcsw LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jean Brunk Lcsw LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Jean Brunk Lcsw LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jean Brunk Lcsw LLC was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.