ETHAN BRUDNO LPC
NPI 1346054228
Counselor - Professional in Medford, NJ

Active since February 03, 2025PECOS EnrolledAccepts Medicare Assignment
103 OLD MARLTON PIKE STE 101, MEDFORD, NJ 08055(609) 314-1807 Get Directions Write a Review

NPPES record last updated: February 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Brudno Lpc NPPES

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

ETHAN BRUDNO LPC (NPI 1346054228) is an individual professional provider in Medford, New Jersey, licensed in New Jersey (37PC01099500) and active in the NPI registry since February 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1346054228
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameETHAN BRUDNOCredential: LPC
Location Address103 OLD MARLTON PIKE STE 101Medford, NJ 08055-8772
Mailing Address1021 Route 70 W Apt ACherry Hill, NJ 08002-3530
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 3, 2025
NPPES CertifiedFebruary 3, 2025
NPI 1346054228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in NJ · 37PC01099500
103 OLD MARLTON PIKE STE 101, Medford, NJ 08055

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ethan Brudno Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638693914
PECOS Enrollment IDI20250408002118
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Gastroenterology)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Mental Health)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Professional)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Addiction (Substance Use Disorder))
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Professional)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Mental Health)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055
Counselor (Mental Health)
103 OLD MARLTON PIKE STE 101
MEDFORD, NJ 08055

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 Ethan Brudno's NPI number?

The NPI number for Ethan Brudno is 1346054228. It was assigned to this individual provider in the NPPES registry on February 3, 2025.

Where is Ethan Brudno located?

Ethan Brudno practices at 103 Old Marlton Pike Ste 101, Medford, NJ 08055. The listed phone number is (609) 314-1807.

What is Ethan Brudno's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Ethan Brudno enrolled in Medicare?

Yes. Ethan Brudno is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ethan Brudno was last updated on February 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.