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MRS. JORDAN BREE BRUNNER LPC
NPI 1932720430
Counselor - Mental Health in West Bend, WI

Active since May 06, 2020PECOS Enrolled
908 W WASHINGTON ST, WEST BEND, WI 53095(920) 783-6633(920) 783-6392 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 16, 2025, May 6, 2020 (2 updates tracked since 2020).

About Mrs. Jordan Bree Brunner Lpc NPPES

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

MRS. JORDAN BREE BRUNNER LPC (NPI 1932720430) is an individual mental health provider in West Bend, Wisconsin, licensed in Wisconsin (4501-226) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1932720430
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. JORDAN BREE BRUNNERCredential: LPC
Location Address908 W WASHINGTON STWest Bend, WI 53095-2430
Mailing AddressPo Box 959Sheboygan, WI 53082-0959 · (920) 783-6633 · Fax (920) 783-6392
Phone(920) 783-6633
Fax(920) 783-6392
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 6, 2020
Last NPPES UpdateSeptember 16, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2025
✔ NPI 1932720430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WI · 4501-226
908 W WASHINGTON ST, West Bend, WI 53095
Open in Google Maps ↗

Other Names 1

Former Name (1)Jordan B Lesuer-mandernack

Secondary Practice Locations 3

Location 11721 Saemann AveSheboygan, WI 53081-2342 · Phone (920) 783-6633 · Fax (920) 783-6392
Location 2819 Kentucky AveSheboygan, WI 53081-4954 · Phone (920) 783-6633 · Fax (920) 783-6392
Location 32719 Calumet AveManitowoc, WI 54220-5546 · Phone (920) 686-2333 · Fax (920) 686-2334

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jordan Bree Brunner Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183121056
PECOS Enrollment IDI20251007003739
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.

Medicare Billing Reassignment

Medicare enrollment records show Jordan Brunner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lakeshore Community Health Care, Inc
Same address
Federally Qualified Health Center (FQHC)
908 W WASHINGTON ST
West Bend, WI 53095
  • Reassigned Medicare billing, Wisconsin enrollment
  • 46 clinicians in this Medicare group
NPI 1184358004 (920) 783-6633

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

Other Providers at the Same Location NPPES 5

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

LAKESHORE COMMUNITY HEALTH CARE, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
908 W WASHINGTON ST
WEST BEND, WI 53095
Washington County (920) 783-6633
DR. JAMES E ALBRECHT FREE CLINIC, INC.
Clinic/Center (Dental)
908 W WASHINGTON ST
WEST BEND, WI 53095
Washington County (262) 334-8339
MCKAYLA HOEFERT SOCIAL WORKER
Social Worker
908 W WASHINGTON ST
WEST BEND, WI 53095
Washington County (920) 783-6633
ABBEY A BROETZMANN RDH
Dental Hygienist
908 W WASHINGTON ST
WEST BEND, WI 53095
Washington County (920) 783-6633
DR. DONALD M MUTH MD
Internal Medicine
908 W WASHINGTON ST
WEST BEND, WI 53095
Washington County (262) 334-8339

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 Jordan Brunner's NPI number?

The NPI number for Jordan Brunner is 1932720430. It was assigned to this individual provider in the NPPES registry on May 6, 2020. The provider is also known as Jordan B Lesuer-Mandernack.

Where is Jordan Brunner located?

Jordan Brunner practices at 908 W Washington St, West Bend, WI 53095. The listed phone number is (920) 783-6633.

What is Jordan Brunner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jordan Brunner enrolled in Medicare?

Yes. Jordan Brunner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jordan Brunner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Brunner reassigns Medicare benefits to Lakeshore Community Health Care, Inc (West Bend, WI). The 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 Jordan Brunner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jordan Brunner accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan, Network Health and Quartz and 1 other insurer list Jordan Brunner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jordan Brunner was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.